K Number
K233243
Device Name
ClearPoint System (Software Version 2.2)
Date Cleared
2023-11-27

(60 days)

Product Code
Regulation Number
882.4560
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The ClearPoint System is intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment and in conjunction with MR imaging. During planning, the system is intended to provide functionality for the automatic identification, labeling, visualization and quantification of segmentable brain structures from a set of loaded MR images. The ClearPoint System is intended as an integral part of procedures that have traditionally used stereotactic methodology. These procedures include biopsies, catheter and electrode including deep brain stimulation (DBS) lead placement. The System is intended for use only with 1.5 and 3.0 Tesla MRI scanners and MR conditional implants and devices.
Device Description
The updated ClearPoint Software Version 2.2 integrates the ClearPoint Neuro Maestro Brain Model software (K213645) into the previous ClearPoint Software Version 2.1 (K222519). The ClearPoint Maestro™ Brain Model product is a stand-alone software application for automatic labeling, visualization, and quantification of segmentable brain structures from a set of MRI images and has been incorporated into the ClearPoint System software. The ClearPoint System described in this submission is essentially identical from a technological standpoint to the cleared predicate device described in K222519 (ClearPoint System). As mentioned above, since the prior clearance, the company has integrated the Maestro Brain Model into the software of the predicate device. Specifically, the company has released an updated version of software 2.1, which was part of the last clearance, and has now been upgraded to software 2.2. The ClearPoint System is comprised of a workstation laptop with software, the SMARTGrid™ MRI-Guided Planning Grid, the SMARTFrame™ MRI-Guided Trajectory Frame, the SMARTFrame™ Accessory Kit and the SMARTFrame™ Thumbwheel Extension. The SMARTGrid and associated Marking Tool are designed to assist the physician to precisely position the entry hole as called out in the trajectory planning software. The SMARTFrame is an Adjustable Trajectory Frame (ATF) that provides the guidance and fixation for neurosurgical tools. The MRI visible fluids of the Targeting Cannula along with the fiducial markers in the base of the frame allow for trajectory feedback when the physician views the MRI images, makes changes and confirms with subsequent MR images. The ClearPoint System can be used with any MRI-compatible head fixation frame to immobilize the patient's head with respect to the scanner table, as well as with any imaging coil(s) (supplied by scanner manufacturers) that meet the physician's desired imaging quality. ClearPoint Neuro also supplies an optional head fixation frame that can be used with the ClearPoint System. The ClearPoint Workstation includes the following: 1. ClearPoint Workstation Software (for trajectory planning and monitoring) 2. Laptop Computer The hardware components of the current ClearPoint System are the SMARTFrame and Accessories. They are all single use devices that are provided sterile and include the following: 1. SMARTGrid MRI Planning Grid (interacts with the software to determine the desired location of the burr hole) a. Marking Grid b. Marking Tool 2. SMARTFrame Pack (SMARTFrame or SMARTFrame XG) a. SMARTFrame ("ATF") with Base b. Centering Device and Wharen Centering Guide c. Dock d. Device Lock (2 different diameters) e. Screwdriver f. Roll Lock Screw and Washer 3. Rescue Screws (Extra Titanium Screws) 4. Thumbwheel Extension 5. Accessory Kit a. Peel-away Sheath b. Stylet c. Lancet d. Depth Stop e. Ruler 6. Scalp Mount Base 7. Guide Tubes and Device Guide Packs (Guide Cannulas) In addition, the ClearPoint System is used with the following separately cleared or Class I, 510(k)-exempt products: SmartTip MRI Hand Drill and Drill Bit Kit MRI Neuro Procedure Drape, with Marker Pen and Cover SmartFrame MR Fiducial Each of the above packs is sold separately and is intended to be used with the ClearPoint Workstation. Each of the components has been described in detail in previous submissions. The ClearPoint System described in this 510(k) is a modification to the company's cleared ClearPoint System (K222519).
More Information

Not Found

Unknown
The description mentions "automatic identification, labeling, visualization and quantification of segmentable brain structures" and the integration of the "ClearPoint Neuro Maestro Brain Model software" which performs "automatic labeling, visualization, and quantification". While these functions could potentially be implemented using AI/ML, the summary does not explicitly state that AI, ML, or related technologies like DNNs are used. The lack of information on training and test sets further contributes to the uncertainty.

No.
The ClearPoint System provides guidance for neurological procedures and does not directly deliver therapy or treat a disease.

No

Explanation: The ClearPoint System is intended for stereotactic guidance during neurological procedures, facilitating instrument placement and operation within the MRI environment. While it processes MR images to identify and visualize brain structures for planning, its primary function is guidance for interventional procedures (biopsies, lead placements), not for diagnosing conditions.

No

The device description explicitly lists multiple hardware components that are part of the ClearPoint System, including the SMARTGrid, SMARTFrame, and various accessories. While it includes software, it is not solely software.

Based on the provided information, the ClearPoint System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states that the system is for "stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment." This describes a surgical guidance system, not a device used to examine specimens derived from the human body for the purpose of providing information for diagnosis, monitoring, or compatibility testing.
  • Device Description: The description details hardware components like frames, grids, cannulas, and software for trajectory planning and monitoring. These are tools used during a medical procedure, not for analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing blood, tissue, or other bodily fluids or substances. The system's function is to assist in physically guiding instruments within the brain based on imaging data.

While the system uses image processing and provides information about brain structures, this information is used for surgical planning and guidance, not for making a diagnosis based on the analysis of biological specimens.

N/A

Intended Use / Indications for Use

The ClearPoint System is intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment and in conjunction with MR imaging. During planning, the system is intended to provide functionality for the automatic identification, labeling, visualization and quantification of segmentable brain structures from a set of loaded MR images. The ClearPoint System is intended as an integral part of procedures that have traditionally used stereotactic methodology. These procedures include biopsies, catheter and electrode including deep brain stimulation (DBS) lead placement. The System is intended for use only with 1.5 and 3.0 Tesla MRI scanners and MR conditional implants and devices.

Product codes (comma separated list FDA assigned to the subject device)

HAW, QIH

Device Description

The updated ClearPoint Software Version 2.2 integrates the ClearPoint Neuro Maestro Brain Model software (K213645) into the previous ClearPoint Software Version 2.1 (K222519). The ClearPoint Maestro™ Brain Model product is a stand-alone software application for automatic labeling, visualization, and quantification of segmentable brain structures from a set of MRI images and has been incorporated into the ClearPoint System software. The ClearPoint System described in this submission is essentially identical from a technological standpoint to the cleared predicate device described in K222519 (ClearPoint System). As mentioned above, since the prior clearance, the company has integrated the Maestro Brain Model into the software of the predicate device. Specifically, the company has released an updated version of software 2.1, which was part of the last clearance, and has now been upgraded to software 2.2.

The ClearPoint System is comprised of a workstation laptop with software, the SMARTGrid™ MRI-Guided Planning Grid, the SMARTFrame™ MRI-Guided Trajectory Frame, the SMARTFrame™ Accessory Kit and the SMARTFrame™ Thumbwheel Extension. The SMARTGrid and associated Marking Tool are designed to assist the physician to precisely position the entry hole as called out in the trajectory planning software. The SMARTFrame is an Adjustable Trajectory Frame (ATF) that provides the guidance and fixation for neurosurgical tools. The MRI visible fluids of the Targeting Cannula along with the fiducial markers in the base of the frame allow for trajectory feedback when the physician views the MRI images, makes changes and confirms with subsequent MR images.

The ClearPoint System can be used with any MRI-compatible head fixation frame to immobilize the patient's head with respect to the scanner table, as well as with any imaging coil(s) (supplied by scanner manufacturers) that meet the physician's desired imaging quality. ClearPoint Neuro also supplies an optional head fixation frame that can be used with the ClearPoint System.

The ClearPoint Workstation includes the following:

  1. ClearPoint Workstation Software (for trajectory planning and monitoring)
  2. Laptop Computer

The hardware components of the current ClearPoint System are the SMARTFrame and Accessories. They are all single use devices that are provided sterile and include the following:

  1. SMARTGrid MRI Planning Grid (interacts with the software to determine the desired location of the burr hole)
  • Marking Grid a.
  • b. Marking Tool
  1. SMARTFrame Pack (SMARTFrame or SMARTFrame XG)
  • a. SMARTFrame ("ATF") with Base
  • b. Centering Device and Wharen Centering Guide
  • c. Dock
  • d. Device Lock (2 different diameters)
  • Screwdriver e.
  • f. Roll Lock Screw and Washer
  1. Rescue Screws (Extra Titanium Screws)
  2. Thumbwheel Extension
  3. Accessory Kit
  • a. Peel-away Sheath
  • b. Stylet
  • c. Lancet
  • d. Depth Stop
  • e. Ruler
  1. Scalp Mount Base
  2. Guide Tubes and Device Guide Packs (Guide Cannulas)

In addition, the ClearPoint System is used with the following separately cleared or Class I, 510(k)-exempt products:

  • SmartTip MRI Hand Drill and Drill Bit Kit
  • MRI Neuro Procedure Drape, with Marker Pen and Cover
  • SmartFrame MR Fiducial ●

Each of the above packs is sold separately and is intended to be used with the ClearPoint Workstation. Each of the components has been described in detail in previous submissions. The ClearPoint System described in this 510(k) is a modification to the company's cleared ClearPoint System (K222519).

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

MR imaging

Anatomical Site

Brain

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Physician, MRI Suite

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

ClearPoint Neuro performed extensive Non-Clinical Verification Testing to evaluate the safety and performance of the software components of ClearPoint System (Software Version 2.2). The following software verification testing was performed:

  • Automated Verification ●
  • Integrated System Verification
  • Localization Verification ●
  • Regression Test Verification ●
  • Manual Testing .

The results of all testing met the acceptance criteria and demonstrated that the proposed ClearPoint System (Software Version 2.2) complies with all design specifications and performs as expected.

Accuracy testing was performed to confirm that modifications included in ClearPoint System 2.2 did not cause any unexpected changes in the accuracy specifications of the software, with successful results.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Positional Error (mm): Mean (X,Y,Z) 0.14, Std. Dev. 0.37, 99% CI 0.44; 0.16, 0.54, 0.60; 0.56, 0.57, 0.10
Angular Error (deg.): Mean 0.32°, Std. Dev. 0.17°, 99% CI 0.46°

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K222519, K213645

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 882.4560 Stereotaxic instrument.

(a)
Identification. A stereotaxic instrument is a device consisting of a rigid frame with a calibrated guide mechanism for precisely positioning probes or other devices within a patient's brain, spinal cord, or other part of the nervous system.(b)
Classification. Class II (performance standards).

0

November 27, 2023

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

ClearPoint Neuro Inc. Brennan Sullivan Regulatory Affairs Manager 120 S. Sierra Avenue, Suite 100 Solana Beach, California 92075

Re: K233243

Trade/Device Name: ClearPoint System (Software Version 2.2) Regulation Number: 21 CFR 882.4560 Regulation Name: Neurological Stereotaxic Instrument Regulatory Class: Class II Product Code: HAW, QIH Dated: September 28, 2023 Received: September 28, 2023

Dear Brennan Sullivan:

We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

1

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerelv.

Image /page/1/Picture/6 description: The image shows the name "Adam D. Pierce -S" in large, bold font. To the right of the name, there is a digital signature that also says "Adam D. Pierce -S". The signature includes the date "2023.11.27" and the time "13:25:33-05'00'".

Adam D. Pierce, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices

2

Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) Number (if known) K233243

Device Name

ClearPoint System (Software Version 2.2)

Indications for Use (Describe)

The ClearPoint System is intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment and in conjunction with MR imaging. During planning, the system is intended to provide functionality for the automatic identification, labeling, visualization and quantification of segmentable brain structures from a set of loaded MR images. The ClearPoint System is intended as an integral part of procedures that have traditionally used stereotactic methodology. These procedures include biopsies, catheter and electrode including deep brain stimulation (DBS) lead placement. The System is intended for use only with 1.5 and 3.0 Tesla MRI scanners and MR conditional implants and devices.

Type of Use (Select one or both, as applicable)
Prescription Use (Part 21 CFR 801 Subpart D)Over-The-Counter Use (21 CFR 801 Subpart C)

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4

510(k) Summary

A. Device Information

CategoryComments
Sponsor:ClearPoint Neuro, Inc.
6349 Paseo Del Lago
Carlsbad, CA 92011
Correspondent Contact
Information:Brennan Sullivan
120 S. Sierra Ave.
Solana Beach, CA 92075
617-678-1028
bsullivan@clearpointneuro.com
Device Common Name:Neurological Stereotactic Instrument
Device Regulation & Name:Neurological Stereotaxic Instrument, 21CFR
882.4560
Classification & Product Code:Class II
HAW
510(k) Number:K233243
Device Proprietary Name:ClearPoint System Software Version 2.2

Primary Predicate Device Information:

Predicate Device:ClearPoint System (v2.1)
Predicate Device Manufacturer:ClearPoint Neuro, Inc.
Predicate Device Common Name:Neurological Stereotactic Instrument
Predicate Device Premarket Notification #K222519
Predicate Device Classification & NameNeurological Stereotaxic Instrument,
21CFR 882.4560
Predicate Device Classification &
Product Code:Class II
HAW

Additional Predicate Device Information:

Predicate Device:ClearPoint Maestro Brain Model
Predicate Device Manufacturer:ClearPoint Neuro, Inc.
Predicate Device Common Name:System, Image Processing,
Radiological
Predicate Device Premarket Notification #K213645
Predicate Device Classification & NameMedical Imaging Management and
Processing System, 21CFR 892.2050
Predicate Device Classification &
Product Code:Class II
QIH

5

B. Date Summary Prepared

November 27, 2023

C. Description of Device

The updated ClearPoint Software Version 2.2 integrates the ClearPoint Neuro Maestro Brain Model software (K213645) into the previous ClearPoint Software Version 2.1 (K222519). The ClearPoint Maestro™ Brain Model product is a stand-alone software application for automatic labeling, visualization, and quantification of segmentable brain structures from a set of MRI images and has been incorporated into the ClearPoint System software. The ClearPoint System described in this submission is essentially identical from a technological standpoint to the cleared predicate device described in K222519 (ClearPoint System). As mentioned above, since the prior clearance, the company has integrated the Maestro Brain Model into the software of the predicate device. Specifically, the company has released an updated version of software 2.1, which was part of the last clearance, and has now been upgraded to software 2.2.

The ClearPoint System is comprised of a workstation laptop with software, the SMARTGrid™ MRI-Guided Planning Grid, the SMARTFrame™ MRI-Guided Trajectory Frame, the SMARTFrame™ Accessory Kit and the SMARTFrame™ Thumbwheel Extension. The SMARTGrid and associated Marking Tool are designed to assist the physician to precisely position the entry hole as called out in the trajectory planning software. The SMARTFrame is an Adjustable Trajectory Frame (ATF) that provides the guidance and fixation for neurosurgical tools. The MRI visible fluids of the Targeting Cannula along with the fiducial markers in the base of the frame allow for trajectory feedback when the physician views the MRI images, makes changes and confirms with subsequent MR images.

The ClearPoint System can be used with any MRI-compatible head fixation frame to immobilize the patient's head with respect to the scanner table, as well as with any imaging coil(s) (supplied by scanner manufacturers) that meet the physician's desired imaging quality. ClearPoint Neuro also supplies an optional head fixation frame that can be used with the ClearPoint System.

The ClearPoint Workstation includes the following:

    1. ClearPoint Workstation Software (for trajectory planning and monitoring)
    1. Laptop Computer

The hardware components of the current ClearPoint System are the SMARTFrame and Accessories. They are all single use devices that are provided sterile and include the following:

    1. SMARTGrid MRI Planning Grid (interacts with the software to determine the desired location of the burr hole)

6

ClearPoint Neuro, Inc.

ClearPoint System Software Version 2.2

  • Marking Grid a.
  • b. Marking Tool
    1. SMARTFrame Pack (SMARTFrame or SMARTFrame XG)
    • a. SMARTFrame ("ATF") with Base
    • b. Centering Device and Wharen Centering Guide
    • c. Dock
    • d. Device Lock (2 different diameters)
    • Screwdriver e.
    • f. Roll Lock Screw and Washer
    1. Rescue Screws (Extra Titanium Screws)
    1. Thumbwheel Extension
    1. Accessory Kit
    • a. Peel-away Sheath
    • b. Stylet
    • c. Lancet
    • d. Depth Stop
    • e. Ruler
    1. Scalp Mount Base
    1. Guide Tubes and Device Guide Packs (Guide Cannulas)

In addition, the ClearPoint System is used with the following separately cleared or Class I, 510(k)-exempt products:

  • SmartTip MRI Hand Drill and Drill Bit Kit
  • MRI Neuro Procedure Drape, with Marker Pen and Cover
  • SmartFrame MR Fiducial ●

Each of the above packs is sold separately and is intended to be used with the ClearPoint Workstation. Each of the components has been described in detail in previous submissions. The ClearPoint System described in this 510(k) is a modification to the company's cleared ClearPoint System (K222519).

D. Indications for Use

The ClearPoint System is intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment and in conjunction with MR imaging. During planning, the system is intended to provide functionality for the automatic identification, labeling, visualization and quantification of segmentable brain structures from a set of loaded MR images. The ClearPoint System is intended as an integral part of procedures that have traditionally used stereotactic methodology. These procedures include biopsies, catheter and electrode insertion including deep brain stimulation (DBS) lead placement. The System is intended for use only with 1.5 and 3.0 Tesla MRI scanners and MR conditional implants and devices.

7

E. Comparison of Technological Characteristics

ClearPoint System (Software Version 2.2) is substantially equivalent to the previously cleared ClearPoint System (Software Version 2.1) (K222519). The subject device's hardware is identical in design and technological characteristics. The differences between the proposed and predicate devices are modifications to the software to include additional tunctionality that has been previously cleared in the ClearPoint Neuro Maestro 510(k) (K213645).

Both the proposed and predicate ClearPoint Systems are intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within the MRI environment and in conjunction with MR imaging. Specifically, the following modifications have been made in ClearPoint Software Version 2.2:

  • . Integration of Maestro Brain Model functionalities:
    • O Optional automatic segmentation of anatomical cortical and subcortical structures at user request.
    • o Visualization of brain structure segmentations overlaid semi-transparently onto 2D views of any registered scan.
    • Visualization of brain structure segmentations as polygon models embedded in the o scene in 3D views of any registered scan.
    • o Computation of volume measurements corresponding to each segmented brain structure.
    • O Workflow for verifying the brain structure segmentation results.
    • o Summarizing brain structure volume measurements in a clinical procedure report.
  • Full compatibility with Windows 11 Operating System ●
  • Ability to load color DICOM images stored with RGB Photometric Interpretation. ●
  • . Capabilities to display images in either Neurological or Radiological viewing orientation within the application viewports according to user preference.
  • . Ability to express anatomical coordinate values and associated landmarks relative to an origin point at either the mid-commissure (MCP) point or posterior commissure (PC) point.
  • A new set of measurement graphic tool improvements ●
  • Some workflow-specific optimizations which provide more efficient and generalized software workflow.
  • Translating the software user interface to support nine additional languages.

These modifications were made as part of continuous product improvement efforts. Specifically, the modifications allow for enhanced functionality and compatibility of the ClearPoint System. The inclusion of the Maestro Brain Model functionalities incorporates the functions of a standalone software product that has previously been subject of a cleared 510(k), (K213645). These changes have been verified and validated and do not raise any different questions of safety or effectiveness.

8

  • Optional automatic segmentation of anatomical cortical and subcortical structures at user ● request.
  • Visualization of brain structure segmentations overlaid semi-transparently onto 2D views of any registered scan.
  • Visualization of brain structure segmentations as polygon models embedded in the scene ● in 3D views of any registered scan.
  • Computation of volume measurements corresponding to each segmented brain structure. ●
  • Workflow for verifying the brain structure segmentation results.
  • . Summarizing brain structure volume measurements in a clinical procedure report.

These changes to the ClearPoint System 2.1 Software have been validated and do not impact the safety or efficacy of the device. A substantial equivalence chart comparing the similarities and differences between the ClearPoint System and its predicate device is provided below. The primary differences between the proposed ClearPoint System 2.2 and the predicate are the incorporation of the functionality of an additional 510(k)-cleared device and additional minor differences in the technological characteristics between the Proposed device and the predicate do not raise different questions of safety or efficacy.

| Characteristic | Proposed ClearPoint System
(v2.2) | Primary Predicate
ClearPoint System (v2.1)
K222519 | Reference Predicate
ClearPoint Maestro
K213645 |
|----------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Classification | 21 CFR 882.4560 | 21 CFR 882.4560 | 21 CFR 892.2050 |
| Product Code | HAW | HAW | QIH |
| Indications for Use | The ClearPoint System is intended to
provide stereotactic guidance for the
placement and operation of
instruments or devices during
planning and operation of
neurological procedures within the
MRI environment and in conjunction
with MR imaging. During planning,
the system is intended to provide
functionality for the automatic
identification, labeling, visualization
and quantification of segmentable
brain structures from a set of loaded
MR images. The ClearPoint System
is intended as an integral part of
procedures that have traditionally
used stereotactic methodology.
These procedures include biopsies,
catheter and electrode insertion
including deep brain stimulation
(DBS) lead placement. The System
is intended for use only with 1.5 and | The ClearPoint System is intended to
provide stereotactic guidance for the
placement and operation of
instruments or devices during
planning and operation of
neurological procedures within the
MRI environment and in conjunction
with MR imaging. The ClearPoint
System is intended as an integral part
of procedures that have traditionally
used stereotactic methodology.
These procedures include biopsies,
catheter and electrode insertion
including deep brain stimulation
(DBS) lead placement. The System
is intended for use only with 1.5 and
3.0 Tesla MRI scanners and MR
conditional implants and devices. | ClearPoint Maestro™ Brain
Model is intended for
automatic labeling,
visualization, volumetric and
shape quantification of
segmentable brain structures
from a set of MR images.
This software is intended to
automate the process of
identifying, labelling, and
quantifying the volume and
shape of brain structures
visible in MRI images. |
| | 3.0 Tesla MRI scanners and MR
conditional implants and devices. | | |
| Environment | MRI Suite | MRI Suite | MRI Suite |
| SMARTGrid Pack | MRI Planning Grid & Marking
tool | MRI Planning Grid & Marking
tool | NA |
| SMARTFrame
Pack | SmartFrame XG, Scalp Mount
Base, Bone Screws, Stand-Off
Pins, Screwdriver, Centering
Tool, Wharen Centering Guide
(packaged and sold separately),
Dock and Lock, Roll Lock Screw
with Washer, Rescue Screws
(packaged separately) | SmartFrame XG, Scalp Mount
Base, Bone Screws, Stand-Off
Pins, Screwdriver, Centering
Tool, Wharen Centering Guide
(packaged and sold separately),
Dock and Lock, Roll Lock
Screw with Washer, Rescue
Screws (packaged separately) | NA |
| Hand Controller | Thumbwheel Extension
(Light Hand Controller) | Thumbwheel Extension (Light
Hand Controller) | NA |
| Accessory pack | Peel away sheath, Lancet, Stylet,
Depth stop, ruler | Peel away sheath, Lancet, Stylet,
Depth stop, ruler | NA |
| Drill Guides | 4.5 mm & 6.0 mm | 4.5 mm & 6.0 mm | NA |
| Targeting Cannula
ID | 0.0825" | 0.0825" | NA |
| Targeting Cannula
Material | Ultem and PEEK | Ultem and PEEK | NA |
| Guide Tube/Device
Guide/Drill Guide
ID | Drill Guide ID: 4.5 mm
(included in SmartFrame Pack)
Drill Guide Tube ID: 3.4 mm
(included in SmartFrame Pack)
Guide Tube ID: 3.2 mm
Guide Tube ID: 2.5 mm
Guide Tube ID: 2.1 mm
Guide Tube ID: 1.7 mm | Drill Guide ID: 4.5 mm
(included in SmartFrame Pack)
Drill Guide Tube ID: 3.4 mm
(included in SmartFrame Pack)
Guide Tube ID: 3.2 mm
Guide Tube ID: 2.5 mm
Guide Tube ID: 2.1 mm
Guide Tube ID: 1.7 mm | NA |
| Targeting Accuracy | ± 1.5 mm @ ≤125mm | ± 1.5 mm @ ≤125mm | NA |
| Packaging | Sterile, Sealed Tray, Inside
Sterile Tyvek Pouch (Wharen
Centering Guide and Drill and
Device Guides are Sterile in a
double Tyvek Pouch Without a
Tray; Wharen Centering Guide
Packaging includes PVC) | Sterile, Sealed Tray, Inside
Sterile Tyvek Pouch (Wharen
Centering Guide and Drill and
Device Guides are Sterile in a
double Tyvek Pouch Without a
Tray; Wharen Centering Guide
Packaging includes PVC) | NA |
| Software | Version 2.2 | Version 2.1 | Version 1.0 |
| Operating System | Windows 10, Windows 11 | Windows 10 | Windows 10 |
| Programming
Languages | Visual C#
Visual C++ | Visual C#
Visual C++ | C++
Qt |
| Visualization
Software Toolkit | Fovia HDVR® | Fovia HDVR® | Visualization Toolkit
(VTK) |
| Visualization
Features | Display of MR and CT images in reformatted (MPR) and 3D views.Cross-reference line display with current plane intersection correlation point indication | Display of MR and CT images in reformatted (MPR) and 3D views.Cross-reference line display with current plane intersection correlation point indication | Display of MR images in reformatted (MPR) and 3D views.Cross-reference line display with current plane intersection |
| ClearPoint Neuro, Inc. | | | K233243 |
| ClearPoint System Software Version 2.2 | | | Page 7 of 10 |
| | Display of 2D annotations and overlays on rendered images General interactive tools (e.g., pan, zoom, width/level, etc.) 3D display of hardware models of the SMARTGrid and SMARTFrame along with volumetric image sets | Display of 2D annotations and overlays on rendered images General interactive tools (e.g., pan, zoom, width/level, etc.) 3D display of hardware models of the SMARTGrid and SMARTFrame along with volumetric image sets | correlation point indication Display of 2D annotations and overlays on rendered images General interactive tools (e.g., pan, zoom, width/level, etc.) |
| DICOM Toolkit | MergeCOM-3 Dicom Toolkit® | MergeCOM-3 Dicom Toolkit® | Insight Toolkit (ITK) |
| DICOM Features | Transfer of images from MR scanner through network (TCP/IP) Browse/load images from media/local storage Configuration and testing of image transfer from scanner to workstation Load enhanced/compressed DICOM images Load color DICOM images that are stored with RGB Photometric Interpretation | Transfer of images from MR scanner through network (TCP/IP) Browse/load images from media/local storage Configuration and testing of image transfer from scanner to workstation Load enhanced/compressed DICOM images | Browse/load images from media/local storage Load enhanced / compressed DICOM images Export bitmask of segmented brain structures in DICOM format |
| Image Registration
Framework | Insight Toolkit (ITK) | Insight Toolkit (ITK) | NA |
| Image
Fusion/Registration | Ability to automatically register/fuse MR-to-MR and MR-to-CT images acquired in different frames of reference Ability to seed automatic registration/fusion based on an initial input transform Slider control used to set the relative weight of the two blended image volumes Tools for reviewing the accuracy of registration and manual override capabilities | Ability to automatically register/fuse MR-to-MR and MR-to-CT images acquired in different frames of reference Ability to seed automatic registration/fusion based on an initial input transform Slider control used to set the relative weight of the two blended image volumes Tools for reviewing the accuracy of registration and manual override capabilities | NA |
| Volume of Interest
Definition | Ability to define and visualize 3D structures within a loaded image set Tools for defining 3D volumes of interest manually Display and computation of volume interest measurements (e.g., total volume, volume overlap) | Ability to define and visualize 3D structures within a loaded image set Tools for defining 3D volumes of interest manually Display and computation of volume interest measurements (e.g., total volume, volume overlap) | NA |
| | | ClearPoint System Software Version 2.2 | Page 8 of 10 |
| Image
Segmentation
Algorithm | Algorithm to automatically
identify anterior commissure
(AC) and posterior
commissure (PC) locations
within the brain. This
algorithm has the same
implementation as in the
predicate device. Algorithms to automatically
locate and identify marking
grid, targeting frame
components, cannula, and
device tip. These algorithms
have the same
implementation as in the
predicate device. Automated measurement of
brain tissue volumes and
structures. This algorithm
has the same
implementation as the
predicate device. Automatic segmentation and
quantification of brain
structures using proprietary
shape-constrained
segmentation algorithms.
These algorithms have the
same implementation as the
predicate device. | Algorithm to automatically
identify anterior commissure
(AC) and posterior
commissure (PC) locations
within the brain.
Algorithms to automatically
locate and identify marking
grid, targeting frame
components, cannula, and
device tip. | Automated
measurement of brain
tissue volumes and
structures.
Automatic
segmentation and
quantification of brain
structures using
proprietary shape-
constrained
segmentation
algorithms. |
| Scan Plane
Parameters | Geometric computations to
display position and orientation
of prescribed scan plane
parameters for Siemens, Philips,
and GE MR scanner
manufacturers. | Geometric computations to
display position and orientation
of prescribed scan plane
parameters for Siemens, Philips,
and GE MR scanner
manufacturers. | NA |
| Hardware
Adjustment
Computations | Computations used to indicate
required frame adjustments
needed to adjust cannula to
desired trajectory. These
computations are the same as in
the predicate device | Computations used to indicate
required frame adjustments
needed to adjust cannula to
desired trajectory | NA |
| Low-Level Math
Library | Low-level math utilities used for
geometric computations. These
utilities are the same as in the
predicate device | Low-level math utilities used for
geometric computations. | Identical |
| Workflow | Optional workflow for initiating
an automatic segmentation of
brain structures from a loaded
MR scan and visualizing /
verifying the results. | No ability to perform automatic
segmentation of brain structures
from a loaded MR scan. | Optional workflow for
initiating an automatic
segmentation of brain
structures from a loaded
MR scan and
|
| | | | visualizing/verifying the
results. |
| | Visualize segmented brain
structures as overlays on any
scan loaded into the application | No ability to visualize segmented
brain structures | Visualize segmented
brain structures as
overlays on a reference
scan loaded into the
application |
| | Output volumetric
measurements corresponding to
each segmented brain structure | No ability to present volume
measurements for segmented
brain structures | Output volumetric
measurements
corresponding to each
segmented brain structure |

Table 1: Side-by-side comparison of ClearPoint System (Software Version 2.2) with Predicate Device

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K233243

10

ClearPoint Neuro, Inc. ClearPoint Neuro, Inc.

ClearPoint System Software Version 2,2

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F. Summary of Supporting Data

ClearPoint Neuro performed extensive Non-Clinical Verification Testing to evaluate the safety and performance of the software components of ClearPoint System (Software Version 2.2). The following software verification testing was performed:

  • Automated Verification ●
  • Integrated System Verification
  • Localization Verification ●
  • Regression Test Verification ●
  • Manual Testing .

The results of all testing met the acceptance criteria and demonstrated that the proposed ClearPoint System (Software Version 2.2) complies with all design specifications and performs as expected.

G. Discussion of Performance Data

Accuracy testing was performed to confirm that modifications included in ClearPoint System 2.2 did not cause any unexpected changes in the accuracy specifications of the software, with successful results. Table 2 outlines the demonstrated accuracy specifications of ClearPoint System.

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ClearPoint Neuro, Inc. K233243 ClearPoint System Software Version 2.2 Page 10 of 10

Performance ValidationPositional Error (mm)Angular Error (deg.)
ClearPoint SystemMean (X,Y,Z)Std. Dev.99% CIMeanStd. Dev.99% CI
0.140.370.440.32°0.17°0.46°
0.160.540.60
0.560.570.10

Table 2: ClearPoint System Accuracy Specifications

H. Conclusion

The subject ClearPoint System (Version 2.2) and the predicate ClearPoint System (Version 2.1) have similar indications for use, technological characteristics, and principles of operation. In addition, the minor differences in the ClearPoint Version 2.2 Software do not alter the fundamental clinical purpose or present different questions of safety or effectiveness as compared to the ClearPoint System 2.1 predicate. Thus, the ClearPoint System Version 2.2 Software is substantially equivalent to the ClearPoint System 2.1 (K222519).