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Aktina Thermoplastic Masks are medical devices used for patient positioning and immobilization during external beam radiation therapy procedures. Thermoplastic masks are intended for the duration of the treatment.

This is a Traditional 510(k) for the Aktina Medical Thermoplastic Mask. The low-temperature thermoplastic mask is made of Aquaplast polycaprolactone sheets. When immersed in water heated to 70-75°C [160 to 170°F], the material softens, allowing the user to shape or stretch the mask over the contours of the patient's anatomy while cooling. When the material reaches room temperature, the mask hardens into the anatomical shape. The mask can then be placed over the patient treatment area to consistently immobilize the area from treatment to treatment. Predicate device manufacturers have used polycaprolactone materials for this intended use for over 25 years. The mask also has a polycarbonate frame with holes for mounting to the user's existing patient support hardware.

The Circular Small Field Collimators, Elekta Integrated, are intended for use with the Elekta line of digital medical linear accelerators (LINAC) for the creation of small circular fields. These fields are used for patients who require external beam radiation therapy or stereotactic radiosurgery of the cranial or extra cranial regions for the treatment of tumors or lesions.

This is a Traditional 510(k) that describes the Circular Small Field Collimators, Elekta Integrated, 50-370, a tertiary collimation system used in conjunction with digital medical linear accelerators (LINAC) for external beam radiation therapy. It consists of collimator cone inserts and a cone insert mounting adapter. The collimator cone inserts create small circular fields of various sizes. Each cone insert is uniquely identified with the diameter in millimeters on the top and bottom covers. The cone mounting adapter is inserted directly into the beam block tray slot of the LINAC head without any need for modification to the LINAC. The collimator cones are easily inserted into and removed from the mounting adapter without removing the adapter from the LINAC. The collimator cone inserts are also uniquely identified electronically, and use the LINAC beam block tray electronic interlock to prevent irradiation, if the cone insert size does not conform to the treatment plan.

The Active Breathing Coordinator is indicated for use when there is a need to reduce the anatomical movement in the thorax and abdomen caused by breathing and cardian motion. It is intended for breath-hold (BH) during simulation and delivery of External Beam Radiation Therapy (EBRT) using photons, in single or multiple fractions, administered via static and/or dynamic delivery processes, in any and all areas of the body where such treatment is indicated. It also provides electrical prompts and status information for the Elekta Limited Response™ gating interface when automated gating of the linac is used. The Active Breathing Coordinator is specifically indicated for: a. Breast tumors, including total and partial breast irradiation techniques, where immobilized anatomy provided by deep inspiration breath-hold (DIBH) allows critical organ sparing, such as decreasing radiation dose to heart, lung and other surrounding normal tissue. b. Lung cancers and other thoracic tumors (such as esophagus, lymphoma, and metastatic lesions) where immobilized anatomy provided by DIBH allows critical organ sparing, including reducing both dose and volume of irradiated normal tissue, and enabling potential reduction of tumor target margins. Also included is the use of linac-based Stereotactic Radiosurgery (SRS) and Stereotactic Radiation Therapy (SRT) that may be employed to treat such lesions. c. Liver tumors, where immobilized anatomy provides critical organ sparing, including reducing both dose and volume of rradiated normal tissue enabling potential reduction of tumor target tissue margins. Also included is the use of linacbased SRS and SRT that may be employed to treat such lesions. d. Pancreatic tumors, where immobilized anatomy allows critical organ sparing including reducing both dose and volume of irradiated normal tissue, enabling potential reduction of tumor target tissue margins. Also included is the use of linacbased SRS and SRT that may be employed to treat such lesions.

This Special 510(k) describes the addition of an alternative mouthpiece and filter kit (Aktina Part Number: 12-210) for the Active Breathing Coordinator (ABC). There is no change to the intended use or indications for use with this modification. The ABC is a flow meter device that allows radiation therapy patients to graphically observe the volume of air that enters and exits their lungs on a computer monitor. The patients are coached prior to the treatment and instructed to hold their breath when the volume of air entering or exiting their lungs reaches a predefined threshold volume. Accurate and reproducible timing of the breath hold period is aided by a patient controlled balloon valve which is connected to the flow meter device. Radiation is only delivered during the breath hold period. Radiation may be delivered by the therapist manually turning the beam on and off, or automatically by using the Elekta Limited Response™ gating interface (FDA 510(k) clearance number K123808, available separately from Elekta, Ltd., Crawley, UK).