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The Senographe DS and Senographe Essential FFDM systems generate digital mammographic images that can be used for screening and in the diagnosis of breast cancer. The Senographe DS and Senographe Essential FFDM systems are intended to be used in the same clinical applications as traditional film-based mammographic systems. Premium View is an image-processing algorithm, which increases the visibility of breast structures. The main advantage is to provide a single breast image, where the contrast in the fatty tissues is similar to that obtained by setting WW (window width) and WL (window level) for optimum visualization of fatty tissues, and the contrast in the fibro-glandular tissue is similar to that obtained by setting WW and WL for optimal visualization of fibro-glandular tissues. PV i is an option that can simplify the presentation of mammographic images, improve workflow, and streamline the review process of images with very dark or bright areas by presenting the image with the WW and WL optimized for review with minimal need for the user to make adjustments for the various tissue areas. This could be especially useful with patients who have very dense breasts, or implants that currently require multiple adjustments of WW and WL to review.

The Senographe DS and Senographe Essential are both full field digital mammography systems consisting of a digital detector, a dual track x-ray tube (molybdenum / rhodium) and an x-ray generator with control. The digital detector is a flat panel of amorphous silicon on which cesium iodide is deposited to maximize the detection of x-rays. The x-ray filter is a wheel with both a molybdenum and a rhodium filter to allow various combinations of xray tube track and filter when imaging breasts of different radiological densities. The system includes a feature called Automatic Optimization of Parameters (AOP) that automatically selects the kVp, the optimal x-ray tube track and beam filtration and then terminates the exposure based on the breast density to provide consistent image quality for the user across a wide range of breast sizes and densities. The subject of this submission will introduce a modification to a previously approved (P990066 / S015 and P990066 S020) image processing algorithm called Premium View. Premium View is an image-processing algorithm, which increases the visibility of breast structures. The main advantage is to provide a single breast image, where the contrast in the fatty tissues is similar to that obtained by setting WW (window width) and WL (window level) for optimum visualization of fatty tissues, and the contrast in the fibro-glandular tissue is similar to that obtained by setting WW and WL for optimal visualization of fibro-glandular tissues. Premium View i, when utilized with the Senographe DS or Senographe Essential introduces a software change that applies different LUT values during the image processing prior to display of a very dense breast, or one with implants. This Premarket Notification will implement this technology on GE Healthcare's existing Full Field Digital Mammography systems as an upgrade to existing systems, or as an option to new installations.

Contrast Enhanced Spectral Mammography (CESM) is an extension of the existing indication for diagnostic mammography with the Senographe Essential or Senographe DS. The CESM application shall enable contrast enhanced breast imaging using a dual energy technique. This imaging technique can be used as an adjunct following mammography and ultrasound exams to localize a known or suspected lesion.

The Senographe DS and Senographe Essential are both full field digital mammography systems consisting of a digital detector, a dual track x-ray tube (molybdenum / rhodium) and an x-ray generator with control. The digital detector is a flat panel of amorphous silicon on which cesium iodide is deposited to maximize the detection of x-rays. The x-ray filter is a wheel with both a molybdenum and a rhodium filter to allow various combinations of x-ray tube track and filter when imaging breasts of different radiological densities. The system includes a feature called Automatic Optimization of Parameters (AOP) that automatically selects the kVp, the optimal x-ray tube track and beam filtration and then terminates the exposure based on the breast density to provide consistent image quality for the user across a wide range of breast sizes and densities. The subject of this submission is a modification that will introduce a new imaging option based on a method of image acquisition involving a x-ray exposures at two energy levels. The two exposures will be completed at the simultaneously using a technique known as "dualenergy". This x-ray acquisition methodology has been previously cleared by GE Healthcare in K013481, although that clearance excludes mammography. This Premarket Notification will implement this technology on GE Healthcare's existing Full Field Digital Mammography systems as an upgrade to existing systems, or as an option to new installations. The dualenergy exposures will be done with a single breast compression and will be following an iodine based contrast injection of an existing approved x-ray contrast agent, using the approved rate, route of administration, and dosage of the contrast agent. The new mode of operation is referred to as Contrast Enhanced Spectral Mammography (CESM) due to the nature of taking an exposure with the x-ray spectrum optimized for general mammographic imaging and a second exposure with the x-ray spectrum optimized for the iodine based contrast image. The modification also includes the implementation of an additional x-ray beam filter. The change in x-ray exposure energy, plus the change in beam filtration allow the system to optimize the x-ray spectrum for the iodine based contrast when acquiring the second exposure of the dual-energy acquisition. This filtration change is done by rotating the filter wheel and changing the beam filter selected for the high energy exposure. These two images are combined to allow visualization of the breast tissue in a way that is typical and familiar for mammographic imaging, while being able to visualize the x-ray contrast enhancement in the breast at the same time.