(207 days)
uAI Portal is a software solution intended to be used for viewing, manipulation, and storage of medical images. It supports interpretation of examinations within healthcare institutions. It has the following additional indications:
The Lower Extremity Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating CTA images of lower extremities.
The Head and Neck Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with head and neck CTA.
The Coronary Analysis is intended to provide a tool for viewing, manipulating imaging datasets acquired with CCTA.
The Pulmonary Artery Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with CTPA.
The Aorta Analysis is intended to provide a tool for viewing, and evaluating imaging datasets acquired with aorta CTA.
uAI Portal is a comprehensive software solution designed to process, review and analyze CT studies. It can transfer images in DICOM 3.0 format over a medical imaging network or local file system. These images can be functional data, as well as anatomical datasets. It can be at one or more time-points or include one or more time-frames. Multiple display formats including VR, MIP, MPR, Probe, CPR, and SCPR. A trained, licensed physician can interpret these displayed images as well as the statistics as per standard practice.
uAI Portal contains the following applications:
- The Lower Extremity Vessel Analysis
- . The Head and Neck Vessel Analysis
- . The Coronary Analysis
- . The Pulmonary Artery Analysis
- . The Aorta Analysis
Here's a breakdown of the acceptance criteria and study details for the uAI Portal device, based on the provided FDA 510(k) summary:
1. Acceptance Criteria and Reported Device Performance
The device's performance was evaluated using the Dice coefficient, which measures the similarity between the algorithm's segmentation result (P) and the ground truth (G). The formula used is: $DICE = \frac{2 * G \cap P}{G + P}$.
| Application | Algorithm | Acceptance Criteria (Dice) | Reported Average Dice |
|---|---|---|---|
| Coronary Artery | Vessels segmentation | 0.85 | 0.920 |
| Heart segmentation | 0.90 | 0.980 | |
| Head and Neck Vessel | Head vessel segmentation | 0.85 | 0.902 |
| Neck vessel segmentation | 0.90 | 0.967 | |
| Aorta | Trunk segmentation | 0.90 | 0.946 |
| Branches segmentation | 0.80 | 0.846 | |
| Pulmonary Artery | Arteries segmentation | 0.85 | 0.953 |
| Veins segmentation | 0.85 | 0.933 | |
| Lower Extremity Artery | Arteries segmentation | 0.80 | 0.892 |
All reported average Dice values exceed their respective acceptance criteria.
2. Sample Size and Data Provenance
- Test Set Sample Size: 150 images.
- Data Provenance for Test Set: Collected from the US. The data covered a variety of demographics (gender, age), equipment (SIEMENS, GE, TOSHIBA), and image characteristics (with/without artifacts, with/without anatomical variation).
- Data Provenance for Training Set: Images collected from China. The data set ensured a variety of data for different gender, age, equipment, and CT protocol.
- Retrospective/Prospective: Not explicitly stated, but the mention of "images collected from US" and "images collected from China" for testing and training datasets respectively, combined with the ground truth establishment process involving expert annotation of existing images, strongly suggests a retrospective study design.
3. Number of Experts and Qualifications for Ground Truth
- Number of Experts:
- Initial Annotation: Two (2) Chinese radiologists.
- Adjudication: One (1) American Board-Certified Radiology adjudicator.
- Qualifications of Experts:
- Initial Annotation: Each radiologist had at least 5 years of clinical experience. They were hospital employees and independent of United Imaging.
- Adjudication: The adjudicator was an American Board-Certified Radiology adjudicator with at least 10 years of clinical experience.
4. Adjudication Method for the Test Set
- Method: A 2+1 adjudication method was used.
- Two (2) Chinese radiologists independently annotated the vessel mask for each patient case, resulting in two sets of annotations.
- An American Board-Certified Radiology adjudicator (the "1" in 2+1) reviewed both sets of segmented images.
- Based on their assessment, the adjudicator selected the most accurate segmentation set as the final ground truth. If necessary, they would make modifications until a satisfactory ground truth was established.
5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study
- No, a MRMC comparative effectiveness study was NOT done. The study focused on the standalone algorithmic performance (Dice coefficient) against an expert-established ground truth. There is no mention of human readers assisting or comparing performance with and without AI.
6. Standalone (Algorithm Only) Performance
- Yes, a standalone (algorithm only without human-in-the-loop performance) study was done. The entire "Performance Verification" section details the algorithm's performance in segmenting various anatomical structures by comparing its output (P) to the established ground truth (G) using the Dice coefficient.
7. Type of Ground Truth Used
- The ground truth used was expert consensus / adjudicated expert annotation. Specifically, two radiologists initially annotated cases, and a third, more experienced radiologist adjudicated and finalized the ground truth.
8. Sample Size for the Training Set
- The exact sample size for the training set is not specified, only that images were "collected from China".
9. How the Ground Truth for the Training Set was Established
- The document states that "Algorithm training of uAI Portal software has been conducted on images collected from China as training dataset." However, it does not explicitly detail how the ground truth for this training dataset was established. It implies that these images had associated ground truth data for the algorithm to learn from, but the process of creating that ground truth for the training set is not described in the provided text.
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September 6, 2024
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Shanghai United Imaging Intelligence Co., Ltd. Xiaojing Zhao Ouality & Regulatory Manager No. 701 Yunjin Road, Xuhui District Shanghai, 200232 China
Re: K240411
Trade/Device Name: uAI Portal Regulation Number: 21 CFR 892.2050 Regulation Name: Medical Image Management And Processing System Regulatory Class: Class II Product Code: QIH, LLZ Dated: August 14, 2024 Received: August 15, 2024
Dear Xiaojing Zhao:
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.
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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).
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.
All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.
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-regulatory
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assistance/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).
Sincerely,
Samal for
Jessica Lamb, Ph.D. Assistant Director Imaging Software Team DHT8B: Division of Radiological Imaging Devices and Electronic Products OHT8: Office of Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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Indications for Use
Form Approved: OMB No. 0910-0120 Expiration Date: 07/31/2026 See PRA Statement below.
Submission Number (if known)
K240411
Device Name
uAl Portal
Indications for Use (Describe)
uAl Portal is a software solution intended to be used for viewing, manipulation, and storage of medical images. It supports interpretation of examinations within healthcare institutions. It has the following additional indications:
The Lower Extremity Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating CTA images of lower extremities.
The Head and Neck Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with head and neck CTA.
The Coronary Analysis is intended to provide a tool for viewing, manipulating imaging datasets acquired with CCTA.
The Pulmonary Artery Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with CTPA.
The Aorta Analysis is intended to provide a tool for viewing, and evaluating imaging datasets acquired with aorta CTA.
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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Image /page/4/Picture/0 description: The image shows the text "K240411" in a large, bold font at the top. Below the text is a logo for "United Imaging Intelligence" with the same text in Chinese below it. The logo consists of a series of blue and green triangles arranged in a column.
510 (k) SUMMARY
1. Date of Preparation:
February 8, 2024
2. Sponsor Identification
Shanghai United Imaging Intelligence Co., Ltd.
No. 701 Yunjin Road, Xuhui District, Shanghai, 200232, PEOPLE'S REPUBLIC OF CHINA Contact Person: Xiaojing Zhao Position: Regulatory Specialist Tel: +86-021-67076888-5386 Email: xiaojing.zhao@uii-ai.com Primary Contact Correspondent: MCRA Digital Health Contact Person: Nima Akhlaghi Position: Director, Digital Health, AI & Imaging Center Lead Tel: 202-742-3889 Email: nakhlaghi@mcra.com
3. Identification of Proposed Device
Trade Name: uAI Portal Common Name: Medical image management and processing system Model(s): uAI Portal Regulatory Information Classification Name: Medical image management and processing system Classification: II Product Code: QIH, LLZ Regulation Number: 21 CFR 892.2050 Review Panel: Radiology
4. Identification of Predicate Device(s)
Predicate Device
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510(k) Number: K183170 Device Name: uWS-CT
5. Device Description
uAI Portal is a comprehensive software solution designed to process, review and analyze CT studies. It can transfer images in DICOM 3.0 format over a medical imaging network or local file system. These images can be functional data, as well as anatomical datasets. It can be at one or more time-points or include one or more time-frames. Multiple display formats including VR, MIP, MPR, Probe, CPR, and SCPR. A trained, licensed physician can interpret these displayed images as well as the statistics as per standard practice.
uAI Portal contains the following applications:
- The Lower Extremity Vessel Analysis ●
- . The Head and Neck Vessel Analysis
- . The Coronary Analysis
- . The Pulmonary Artery Analysis
- . The Aorta Analysis
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Image /page/6/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized cluster of triangles in shades of blue and green. To the right of the geometric shape is the company name, "United Imaging Intelligence," written in English, followed by the same name written in Chinese characters below it.
6. Indications for use
uAI Portal is a software solution intended to be used for viewing, manipulation, communication, and storage of medical images. It supports interpretation and evaluation of examinations within healthcare institutions. It has the following additional indications:
- . The Lower Extremity Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating CTA images of lower extremities.
- . The Head and Neck Vessel Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with head and neck CTA.
- . The Coronary Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with CCTA.
- . The Pulmonary Artery Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with CTPA.
- . The Aorta Analysis is intended to provide a tool for viewing, manipulating, and evaluating imaging datasets acquired with aorta CTA.
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Image /page/7/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric design on the left and the company name on the right. The geometric design is made up of several small triangles arranged in a pyramid shape, with the colors ranging from dark blue to light green. The company name is written in both English and Chinese, with "United Imaging Intelligence" on top and "联影智能" below.
7. Summary of Technological Characteristics
uAI Portal offers a fast and user-friendly solution for reconstructing medical images by utilizing automatic segmentation results generated by artificial intelligence algorithms.
The system parses DICOM images, extracts some tags and then fill the information to database. Datachecking is performed based on the information to verify whether the data can be processed by any of the application. Then the algorithms will be called to process the images in memory and output the segmented results. The segmented results will be stored in hard drive. The system uses database to retrieve the information and record some operation status.
Once users select any data and choose one application, the application will start and load the images files to memory. The original images and the processing results can be displayed in the software interface. Various types of views depending on the selected application are displayed by respective algorithms in the software interface. Basic operations like zooming, panning, adjusting window, and measurements can be performed on the displayed images. Users have the options to save images or results to PACS for storage or send them to Filming for printing. Additionally, user configuration is provided, allowing users to customize their settings in each application.
Both the proposed and predicate device have the similar general information, such as Device Classification Name, Product Code, Classification Panel, Intended Use described in Table 1.
The proposed and predicate device also have the same advanced applications in following:
- Lower Extremity Vessel Analysis
- Head and Neck Vessel Analysis
- Coronary Analysis
- . Pulmonary Artery Analysis
- Aorta Analysis
The differences between the proposed and the predicate device are listed as follows:
- The CT Vessel Analysis application of the predicate device includes the Aorta . Analysis application, Head and Neck Vessel Analysis application, Lower Extremity Vessel Analysis application and Pulmonary Artery Analysis
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application of the proposed device; The CT Heart application of the predicate device offer similar functions as Coronary Analysis application of the proposed device.
- The CT Vessel Analysis application of the predicate device provides combined . segmentation results of vessels and inseparable parts of organs, whereas the proposed device provides segmentation results of vessels in the Aorta Analysis application and Pulmonary Artery Analysis application.
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Image /page/9/Picture/0 description: The image contains a logo for United Imaging Intelligence. The logo consists of two parts: a geometric shape on the left and text on the right. The geometric shape is made up of several triangles arranged in a pyramid-like structure, with a gradient of blue and green colors. The text on the right reads "United Imaging Intelligence" in English, followed by "联影智能" in Chinese. The text is in a simple, sans-serif font and is aligned to the left.
Table 1 Comparison of general information
| Item | Proposed DeviceuAI Portal | Predicate DeviceuWS-CT(K183170) | Remark |
|---|---|---|---|
| Device Classification Name | Medical image management and processing system | Picture Archiving and Communications System | The FDA has changed its regulatory classification of PACS (Picture Archiving and Communication Systems), referring to it now as MIMPS (medical image management and processing systems) as part of amended regulatory classification changes made for radiology-specific software. |
| Product Code | QIH, LLZ | LLZ | Both LLZ and QIH are product code of Medical image management and |
| Item | Proposed DeviceuAI Portal | Predicate DeviceuWS-CT(K183170) | Remark |
| RegulationNumber | 21 CFR 892.2050 | 21 CFR 892.2050 | Same |
| Device Class | II | II | Same |
| ClassificationPanel | Radiology | Radiology | Same |
| AdvancedApplication | Yes | Yes | processing system, thedifference betweenthem is use differentalgorithms. |
| Item | Proposed Device | Predicate Device | Remark |
| uAI Portal | uWS-CT(K183170) | ||
| device. | |||
| Intended Use | uAI Portal is a software solution intended tobe used for viewing, manipulation,communication, and storage of medicalimages. It supports interpretation andevaluation of examinations within healthcareinstitutions. It has the following additionalindications:The Lower Extremity Vessel Analysis isintended to provide a tool for viewing,manipulating, and evaluating CTAimages of lower extremities. The Head and Neck Vessel Analysis isintended to provide a tool for viewing,manipulating, and evaluating imagingdatasets acquired with head and neckCTA. | uWS-CT is a software solution intended to beused for viewing, manipulation,communication, and storage of medicalimages. It supports interpretation andevaluation of examinations within healthcareinstitutions. It has the following additionalindications:The CT Oncology application is intendedto support fast-tracking routinediagnostic oncology, staging, and follow-up, by providing a tool for the user toperform the segmentation and volumetricevaluation of suspicious lesions in lungor liver. The CT Colon Analysis application isintended to provide the user a tool to | The intended use isdecreased. Thepredicated deviceincludes moreapplications, which isdiscussed in thefollowing sections, thanthe proposed device.This difference will notimpact the safety andeffectiveness of thedevice. |
| Item | Proposed DeviceuAI Portal | Predicate DeviceuWS-CT(K183170) | Remark |
| The Coronary Analysis is intended toprovide a tool for viewing,manipulating, and evaluating imagingdatasets acquired with CCTA. The Pulmonary Artery Analysis isintended to provide a tool for viewing,manipulating, and evaluating imagingdatasets acquired with CTPA. The Aorta Analysis is intended toprovide a tool for viewing,manipulating, and evaluating imagingdatasets acquired with aorta CTA. | enable easy visualization and efficientevaluation of CT volume data sets of thecolon. The CT Dental application is intended toprovide the user a tool to reconstructpanoramic and paraxial views of jaw. The CT Lung Nodule application isintended to provide the user a tool for thereview and analysis of thoracic CTimages, providing quantitative andcharacterizing information about nodulesin the lung in a single study, or over thetime course of several thoracic studies. The CT Vessel Analysis application isintended to provide a tool for viewing,manipulating, and evaluating CTvascular images. The Inner viewapplication is intended to perform a | ||
| Item | Proposed DeviceuAI Portal | Predicate DeviceuWS-CT(K183170) | Remark |
| virtual camera view through hollowstructures (cavities), such as vessels.The CT Lung Density Analysis application is intended to segment pulmonary, lobes, and airway, providing the user quantitative parameters, structure information to evaluate the lung and airway. The CT Brain Perfusion application is intended to calculate the parameters such as: CBV, CBF, etc. in order to analyze functional blood flow information about a region of interest (ROI) in the brain. The CT Heart application is intended to segment heart and extract coronary artery. It also provides analysis of vascular stenosis, plaque and heart function. | |||
| Item | Proposed Device | Predicate Device | Remark |
| uAI Portal | uWS-CT(K183170)The CT Calcium Scoring application isintended to identify calcifications andcalculate the calcium score. The CTDynamic Analysis application is intendedto provide visualization of the CTdatasets over time with the 3D/4Ddisplay modes. The CT Bone Structure Analysisapplication is intended to providevisualization and labels for the ribs andspine, and support batch function forintervertebral disk. The CT Liver Evaluation application isintended to provide processing andvisualization for liver segmentation andvessel extraction. It also provides a toolfor the user to perform liver separationand residual liver segments evaluation. |
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Image /page/11/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized pyramid or a collection of triangles in shades of blue and green. To the right of the geometric shape is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters.
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Image /page/12/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a stylized cluster of triangles in varying shades of blue and green. To the right of the geometric design is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters. The number 1 is located at the bottom left of the image.
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Image /page/13/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of two parts: a geometric shape on the left and the company name on the right. The geometric shape is made up of several triangles in shades of blue and green. The company name is written in both English and Chinese.
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Image /page/14/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a stylized cluster of triangles in shades of blue and green. To the right of the geometric design, the text "United Imaging Intelligence" is written in English, followed by the Chinese characters "影响 南".
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Image /page/15/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a stylized cluster of angled shapes in shades of blue and green. To the right of the geometric design is the text "United Imaging Intelligence" in a sans-serif font, followed by the same name in Chinese characters below it.
Table 2 SE Discussion for different Advanced Applications
| Application | Function name | Proposed deviceuAI PortalLower ExtremityVessel Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
|---|---|---|---|---|
| LowerExtremityVessel Analysis | Image Browsing | Yes | Yes | Same |
| Image Editing | Yes | Yes | Same | |
| Vessel Segmentation | Yes | Yes | Same | |
| Bone Segmentation | Yes | Yes | Same | |
| Centerline Extraction | Yes | Yes | Same | |
| ROI | Yes | Yes | Same | |
| Measurement | Yes | Yes | Same | |
| Stenosis Measurement | Yes | Yes | Same | |
| Application | Function name | Proposed deviceuAI PortalLower ExtremityVessel Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
| Yes | Yes | Same | ||
| Archive | Yes | Yes | Same | |
| User Configuration | Yes | Yes | Same |
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Image /page/16/Picture/0 description: The image contains a logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized pyramid made of smaller squares in shades of blue and green. To the right of the geometric shape is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters.
| Application | Function name | Proposed deviceuAI PortalHead and NeckVessel Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
|---|---|---|---|---|
| Head and NeckVessel Analysis | Image Browsing | Yes | Yes | Same |
| Head and NeckVessel Analysis | Image Editing | Yes | Yes | Same |
| Application | Function name | Proposed deviceuAI PortalHead and NeckVessel Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
| VesselSegmentation | Yes | Yes | Same | |
| Bone Segmentation | Yes | Yes | Same | |
| CenterlineExtraction | Yes | Yes | Same | |
| Measurement | Yes | Yes | Same | |
| Yes | Yes | Same | ||
| Archive | Yes | Yes | Same | |
| User Configuration | Yes | Yes | Same | |
| Application | Function name | Proposed deviceuAI PortalCoronaryAnalysis | Predicate deviceuWS-CT(K183170)CT Heart | Remark |
| Coronary Analysis | Image Browsing | Yes | Yes | Same |
| Image Editing | Yes | Yes | Same | |
| Heart Segmentation | Yes | Yes | Same | |
| Vessel Segmentation | Yes | Yes | Same | |
| CenterlineExtraction | Yes | Yes | Same | |
| Measurement | Yes | Yes | Same | |
| Stenosis Measurement | Yes | Yes | Same | |
| Application | Function name | Proposed deviceuAI PortalCoronaryAnalysis | Predicate deviceuWS-CT(K183170)CT Heart | Remark |
| Yes | Yes | Same | ||
| Archive | Yes | Yes | Same | |
| User Configuration | Yes | Yes | Same |
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Image /page/17/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a stylized pyramid or a series of interconnected shapes, with a gradient of blue and green colors. To the right of the geometric design, the text "United Imaging Intelligence" is written in English, followed by the same name in Chinese characters.
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Image /page/18/Picture/0 description: The image contains a logo with the text "United Imaging Intelligence" and the Chinese characters "联影智能" underneath. To the left of the text is an abstract graphic composed of several geometric shapes, primarily triangles or trapezoids, arranged in a pyramid-like formation. The shapes are colored in a gradient of blues and greens, with the darker blues at the top transitioning to lighter greens at the bottom. The overall design appears to represent a company or organization focused on imaging and intelligence technologies.
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Image /page/19/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized pyramid made of small squares in shades of blue and green. To the right of the geometric shape is the text "United Imaging Intelligence" in English, with the words stacked on top of each other. Below the English text is the same name in Chinese characters.
| Application | Function name | Proposed deviceuAI PortalPulmonaryArtery Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
|---|---|---|---|---|
| Pulmonary ArteryAnalysis | Image Browsing | Yes | Yes | Same |
| Image Editing | Yes | Yes | Same | |
| Segmentation | Yes | Yes | The CT Vessel Analysis Application of | |
| Application | Function name | Proposed deviceuAI PortalPulmonaryArtery Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
| uWS-CT (K183170) provide vesselsegmentation results with organs. The uAIPortal Pulmonary Artery Analysis offersegmentation results of vessels. For the | ||||
| Measurement | Yes | Yes | Same | |
| Yes | Yes | Same | ||
| Archive | Yes | Yes | Same | |
| User Configuration | Yes | Yes | Same |
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Image /page/20/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized pyramid or a collection of triangles, with a gradient of blue and green colors. To the right of the geometric shape is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters.
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Image /page/21/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized mountain range or a series of stacked triangles, with a gradient of blue and green colors. To the right of the geometric shape is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters.
| Application | Function name | Proposed deviceuAI PortalAorta Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
|---|---|---|---|---|
| Aorta Analysis | Image Browsing | Yes | Yes | Same |
| Aorta Analysis | Segmentation | Yes | Yes | Organ segmentation results have slightdifference due to the different appliedalgorithm of the predicate device andproposed device. For the evaluation ofvessel, those other segmentation differencebetween the predicate device and proposeddevice will not impact the safety andeffectiveness of the device |
| CenterlineExtraction | Yes | Yes | Same | |
| Measurement | Yes | Yes | Same | |
| Lumen Diameter | Yes | Yes | Same | |
| Application | Function name | Proposed deviceuAI PortalAorta Analysis | Predicate deviceuWS-CT(K183170)CT VesselAnalysis | Remark |
| Measurement | ||||
| Yes | Yes | Same | ||
| Archive | Yes | Yes | Same | |
| User Configuration | Yes | Yes | Same |
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Image /page/22/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric shape on the left, resembling a stylized pyramid or a collection of stacked triangles, with a gradient of blue and green colors. To the right of the geometric shape is the text "United Imaging Intelligence" in English, followed by the same name in Chinese characters.
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Image /page/23/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric design on the left and the company name on the right. The geometric design is made up of several triangles in shades of blue and green. The company name is written in English and Chinese, with "United Imaging Intelligence" on top and "联影智能" below.
8. Performance Data
The following performance data were provided in support of the substantial equivalence determination.
Biocompatibility
Not Applicable to the proposed device, because the device is stand-alone software.
Electrical Safety and Electromagnetic Compatibility (EMC)
Not Applicable to the proposed device, because the device is stand-alone software.
Software Verification and Validation
Software verification and validation testing was provided to demonstrate safety and efficacy of the proposed device.
Per FDA Guidance "GUIDANCE FOR THE CONTENT OF PRE-MARKET SUBMISSIONS FOR SOFTWARE CONTAINED IN DEVICES", dated June 14, 2023, the Level of Concern of the software contained in the proposed device is determined to be: Basic Documentation Level.
Those documentations include:
- Software Description
- Risk Management File
- · Software Requirements Specification (SRS)
- · Software Architecture Diagram
- · Software Development Environment Description
- Software Verification and Validation
- · Software Version History
- · Cybersecurity Documents
Animal Study
No animal study was required.
Clinical Studies
No clinical study was required.
Performance Verification
Algorithm training of uAI Portal software has been conducted on images collected from China as training dataset. The data set ensures a variety of data for the different
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gender, age, equipment and CT protocol. Algorithm verification has been conducted on US images.
To validate the uAI Portal software from a clinical perspective, the Al-based segmentation Algorithm contained in the product underwent a scientific evaluation. The results of clinical data-based software validation for the proposed device demonstrated high consistency in comparison to the predicate device.
Regarding the validation of the algorithm, the test data was used independently from training dataset.
The algorithm testing of uAI Portal has been performed using 150 images collected from US, which covered different gender, age, ethnicity, equipment and CT protocol used to collect images. The information of demographic and equipment distribution was as follows:
| Demographic information | Quantity/Years | |
|---|---|---|
| Gender | Female | 73 |
| Male | 77 | |
| Age | Median | 66Y |
| Min | 19Y | |
| Max | 91Y | |
| Equipment | SIEMENS | 55 |
| GE | 85 | |
| TOSHIBA | 10 | |
| Artifacts | With artifacts | 33 |
| Without artifacts | 117 | |
| Anatomical variation | With anatomical variation | 30 |
| Without anatomical variation | 120 |
Acceptance Criteria
In order to verify the effectiveness of the algorithm in the proposed device, we compared the segmentation results with the ground truth. The validation type and acceptance criteria is shown below :
| ValidationType | Application | Algorithm | AcceptanceCriteria |
|---|---|---|---|
| Dice, DICE isdefined asfollows:$DICE = \frac{2 G \cap P }{ G + P }$ ,where G is | Coronary Artery | Vesselssegmentation | 0.85 |
| Heartsegmentation | 0.90 | ||
| Head and NeckVessel | Head vesselsegmentation | 0.85 | |
| Neck vessel | 0.90 |
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Image /page/25/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a cluster of angled blocks in shades of blue and green. To the right of the geometric design is the text "United Imaging Intelligence" in a clear, sans-serif font. Below the English text is the same company name in Chinese characters.
| segmentation | |||
|---|---|---|---|
| the groundtruth, and P isthesegmentationresult. | Aorta | Trunksegmentation | 0.90 |
| Branchessegmentation | 0.80 | ||
| PulmonaryArtery | Arteriessegmentation | 0.85 | |
| Veinssegmentation | 0.85 | ||
| LowerExtremityArtery | Arteriessegmentation | 0.80 |
During the ground truthing process, two Chinese radiologists, each with at least 5 years of clinical experience, independently annotated vessel mask for each patient case, resulting in two sets of annotations per case. Both radiologists are hospital employees and are independent from United Imaging. After completion, an American Board-Certified Radiology adjudicator with at least 10 years of clinical experience reviewed both sets of segmented images. Based on his assessment, the adjudicator selected the most accurate segmentation set as the final ground truth. If needed, he would make any necessary modification until a satisfactory ground truth was established for the study.
The results output by algorithm were compared with the reference standard, the value of Dice coefficient were shown in the table below:
| Application | Algorithm | AverageDice |
|---|---|---|
| Coronary Artery | Vessels segmentation | 0.920 |
| Heart segmentation | 0.980 | |
| Head and Neck Vessel | Head vessel segmentation | 0.902 |
| Neck vessel segmentation | 0.967 | |
| Aorta | Trunk segmentation | 0.946 |
| Branches segmentation | 0.846 | |
| Pulmonary Artery | Arteries segmentation | 0.953 |
| Veins segmentation | 0.933 | |
| Lower Extremity Artery | Arteries segmentation | 0.892 |
The subgroups analysis was conducted based on gender, age, imaging equipment, anatomical variants, and imaging artifacts. The results were shown in the table below:
Coronary Artery Application
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Image /page/26/Picture/0 description: The image contains a logo with the text "United Imaging Intelligence" and "联影智能". The logo consists of a series of triangles arranged in a pyramid shape on the left side. The triangles are colored in shades of blue and green. The text is located to the right of the triangles.
| Algorithm | Gender | Average dice |
|---|---|---|
| Vesselssegmentation | Female | 0.912 |
| Male | 0.924 | |
| Age | Average dice | |
| <40 | 0.915 | |
| 40~60 | 0.920 | |
| >60 | 0.923 | |
| Manufacturer | Average dice | |
| GE | 0.921 | |
| SIEMENS | 0.919 | |
| Artifacts | Average dice | |
| With artifacts | 0.929 | |
| Without artifacts | 0.919 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.909 | |
| Without anatomical variation | 0.922 | |
| Heartsegmentation | Gender | Average dice |
| Female | 0.983 | |
| Male | 0.978 | |
| Age | Average dice | |
| <40 | 0.987 | |
| 40~60 | 0.979 | |
| >60 | 0.979 | |
| Manufacturer | Average dice | |
| GE | 0.977 | |
| SIEMENS | 0.983 | |
| Artifacts | Average dice | |
| With artifacts | 0.983 | |
| Without artifacts | 0.979 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.977 | |
| Without anatomical variation | 0.980 |
Head and Neck Vessel Application
| Algorithm | Gender | Average dice |
|---|---|---|
| Head vessel segmentation | Female | 0.902 |
| Male | 0.902 | |
| Age<40 | 0.905 |
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Image /page/27/Picture/0 description: The image shows the logo for United Imaging Intelligence. The logo consists of a geometric design on the left and the company name on the right. The geometric design is made up of several small triangles in shades of blue and green. The company name is written in English and Chinese.
| 40~60 | 0.903 | |
|---|---|---|
| >60 | 0.901 | |
| Manufacturer | Average dice | |
| GE | 0.899 | |
| SIEMENS | 0.904 | |
| TOSHIBA | 0.910 | |
| Artifacts | Average dice | |
| With artifacts | 0.902 | |
| Without artifacts | 0.902 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.899 | |
| Without anatomical variation | 0.905 | |
| Gender | Average dice | |
| Female | 0.966 | |
| Male | 0.968 | |
| Age | Average dice | |
| <40 | 0.959 | |
| 40~60 | 0.968 | |
| >60 | 0.968 | |
| Neckvesselsegmentation | Manufacturer | Average dice |
| GE | 0.966 | |
| SIEMENS | 0.972 | |
| TOSHIBA | 0.967 | |
| Artifacts | Average dice | |
| With artifacts | 0.968 | |
| Without artifacts | 0.966 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.968 | |
| Without anatomical variation | 0.966 |
Aorta Application
| Algorithm | Gender | Average dice |
|---|---|---|
| Trunksegmentation | Female | 0.941 |
| Male | 0.950 | |
| Age | Average dice | |
| <40 | 0.949 | |
| 40~60 | 0.942 | |
| >60 | 0.947 | |
| Manufacturer | Average dice | |
| GE | 0.940 |
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Image /page/28/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a series of blue and green triangles arranged in a pattern on the left side. To the right of the triangles is the text "United Imaging Intelligence" in English, with the same text written in Chinese below it.
| Branchessegmentation | SIEMENS | 0.955 |
|---|---|---|
| TOSHIBA | 0.948 | |
| Artifacts | Average dice | |
| With artifacts | 0.940 | |
| Without artifacts | 0.947 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.949 | |
| Without anatomical variation | 0.945 | |
| Gender | Average dice | |
| Female | 0.832 | |
| Male | 0.856 | |
| Age | Average dice | |
| <40 | 0.829 | |
| 40~60 | 0.837 | |
| >60 | 0.850 | |
| Manufacturer | Average dice | |
| GE | 0.853 | |
| SIEMENS | 0.830 | |
| TOSHIBA | 0.858 | |
| Artifacts | Average dice | |
| With artifacts | 0.822 | |
| Without artifacts | 0.850 | |
| Anatomical variation | Average dice | |
| With anatomical variation | 0.856 | |
| Without anatomical variation | 0.842 |
Pulmonary Artery Application
| Algorithm | Gender | Average dice |
|---|---|---|
| Arteriessegmentation | Female | 0.955 |
| Male | 0.951 | |
| Age | Average dice | |
| <40 | 0.946 | |
| 40~60 | 0.946 | |
| >60 | 0.957 | |
| Manufacturer | Average dice | |
| GE | 0.956 | |
| SIEMENS | 0.947 | |
| Artifacts | Average dice | |
| With artifacts | 0.960 |
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Image /page/29/Picture/0 description: The image contains a logo with two distinct parts. On the left, there is an abstract geometric design composed of several small, stacked triangles in varying shades of blue and green. To the right of the geometric design, there is text in both English and Chinese. The English text reads "United Imaging Intelligence," and below it, the Chinese text reads "联影智能".
| Without artifacts | 0.953 | |
|---|---|---|
| Anatomical variation | Average dice | |
| With anatomical variation | - | |
| Without anatomical variation | 0.953 | |
| Veinssegmentation | Gender | Average dice |
| Female | 0.936 | |
| Male | 0.930 | |
| Age | Average dice | |
| <40 | 0.944 | |
| 40~60 | 0.926 | |
| >60 | 0.936 | |
| Manufacturer | Average dice | |
| GE | 0.939 | |
| SIEMENS | 0.924 | |
| Artifacts | Average dice | |
| With artifacts | 0.931 | |
| Without artifacts | 0.933 |
Lower Extremity Artery Application
| Algorithm | Gender | Average dice |
|---|---|---|
| Arteriessegmentation | Female | 0.880 |
| Arteriessegmentation | Male | 0.910 |
| Arteriessegmentation | Age | Average dice |
| Arteriessegmentation | 40~60 | 0.881 |
| Arteriessegmentation | >60 | 0.896 |
| Arteriessegmentation | Manufacturer | Average dice |
| Arteriessegmentation | GE | 0.878 |
| Arteriessegmentation | SIEMENS | 0.907 |
| Arteriessegmentation | TOSHIBA | 0.895 |
| Arteriessegmentation | Artifacts | Average dice |
| Arteriessegmentation | With artifacts | 0.906 |
| Arteriessegmentation | Without artifacts | 0.890 |
| Arteriessegmentation | Anatomical variation | Average dice |
| Arteriessegmentation | With anatomical variation | 0.897 |
| Arteriessegmentation | Without anatomical variation | 0.892 |
Other Standards and Guidance
- NEMA PS 3.1 - 3.20 Digital Imaging and Communications in Medicine (DICOM) Set Page 26 of 27
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Image /page/30/Picture/0 description: The image contains the logo for United Imaging Intelligence. The logo consists of a geometric design on the left, resembling a collection of small, tilted squares in varying shades of blue and green. To the right of the geometric design, the text "United Imaging Intelligence" is displayed in a clear, sans-serif font. Below the English text, there is a line of Chinese characters, presumably the Chinese translation of the company's name.
- . ISO 14971 Medical devices - Application of risk management to medical devices (Third Edition 2019-12).
- . IEC 62304 Medical device software - Software life cycle processes (Edition 1.1 2015-06 CONSOLIDATED VERSION).
- . Cybersecurity in Medical Devices: Quality System Considerations and Content of Premarket Submissions (Document issued on September 27, 2023).
The features described in this premarket submission are supported with the results of the testing mentioned above; the uAI Portal was found to have a safety and effectiveness profile that is similar to the predicate device.
Substantially Equivalent (SE) Conclusion 9.
The proposed device is equivalent to the predicate device with regard to safety and efficacy. This conclusion is based upon a comparison of intended use, technological characteristics, performance specification, device hazards as well as verification and validation results.
In summary, the proposed device is determined to be Substantially Equivalent (SE) to the predicate device and reference devices.
§ 892.2050 Medical image management and processing system.
(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).