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510(k) Data Aggregation

    K Number
    K192828
    Date Cleared
    2020-02-13

    (134 days)

    Product Code
    Regulation Number
    892.1750
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Aquilion ONE (TSX-306A/3) V10.0 with Spectral Imaging System

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    This device is indicated to acquire and display cross-sectional volumes of the whole the head, with the capability to image whole organs in a single rotation. Whole organs include, but are not limited to brain, heart, pancreas, etc.

    The Aquilion ONE has the capability to provide volume sets of the entire organ. These volume sets can be used to perform specialized studies, using indicated software, of the whole organ by a trained and qualified physician.

    FIRST is an iterative reconstruction algorithm intended to reduce exposure dose and improve high contrast spatial resolution for abdomen, pelvis, chest, cardiac, extremities and head applications.

    AiCE is a noise reduction algorithm that improves image quality and reduces image noise by employing Deep Convolutional Neural Network methods for abdomen, pelvis, inner ear and extremities applications.

    The Spectral Imaging System allows the system to acquire two nearly simultaneous CT images of an anatomical location using distinct tube voltages and/or tube currents by rapid KV switching. The X-ray dose will be the sum of the dose at each respective tube voltage and current in a rotation.

    Information regarding the material composition of various organs, tissues, and contrast materials may be gained from the differences in X-ray attenuation between these distinct energies.

    When used by a qualified physician, a potential application is to determine the course of treatment.

    Device Description

    Aquilion ONE (TSX-306A/3) V10.0 with Spectral Imaging System is a whole body multi-slice helical CT scanner, consisting of a gantry, couch and a console used for data processing and display. This device captures cross sectional volume data sets used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician. This system is based upon the technology and materials of previously marketed Canon CT systems.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and the studies that prove the device meets them, based on the provided FDA 510(k) summary:

    1. Table of Acceptance Criteria and Reported Device Performance

    The FDA 510(k) summary does not explicitly list numerical "acceptance criteria" in the format of a table with pass/fail thresholds. Instead, it describes various tests and claims that demonstrate substantial equivalence to previously cleared devices. The performance is reported in terms of qualitative assessments (e.g., "diagnostic quality," "substantially equivalent") and quantitative improvements (e.g., "dose reduction," "improvement in low contrast detectability," "noise reduction").

    Here's an interpretation of the implied acceptance criteria and reported performance:

    Feature/Claim TestedImplied Acceptance CriteriaReported Device Performance
    Spectral Imaging
    Image Quality (Bench)Substantially equivalent or improved Contrast-to-Noise Ratios (CNR), CT Number Accuracy, Uniformity, Slice Sensitivity Profile (SSP), Modulation Transfer Function (MTF)-Wire, Standard Deviation of Noise (SD), Noise Power Spectra (NPS), and Low Contrast Detectability (LCD) compared to predicate.Spectral Images are substantially equivalent to the predicate device for all assessed metrics (CNR, CT Number Accuracy, Uniformity, SSP, MTF-Wire, SD, NPS, LCD).
    Artifact Reduction ClaimSpectral Imaging reduces beam hardening artifact (relative to AIDR3D/FBP).Spectral Imaging reduces beam hardening artifact (relative to AIDR3D/FBP).
    Iodine Correlation ClaimHigh linear correlation between CT number and iodine concentration.High linear correlation between CT number and iodine concentration demonstrated.
    Clinical Image QualitySpectral Images for abdomen/pelvis, lung, and extremity applications are of diagnostic quality.Representative abdomen/pelvis, lung, and extremity Spectral Images were confirmed to be of diagnostic quality by an American Board Certified Radiologist.
    AiCE
    Image Quality (Bench)Substantially equivalent or improved CNR, CT Number Accuracy, Uniformity, SSP, MTF-Wire, SD, NPS, LCD, and pediatric phantom/protocol performance compared to predicate.AiCE is substantially equivalent to the predicate device for all assessed metrics (CNR, CT Number Accuracy, Uniformity, SSP, MTF-Wire, SD, NPS, LCD, pediatric phantom/protocol).
    Dose Reduction ClaimDemonstrate significant dose reduction compared to filtered back projection (FBP) for body AiCE.69-81% dose reduction compared to filtered back projection for body AiCE.
    LCD Improvement ClaimDemonstrate improvement in low contrast detectability for body AiCE.18.4% improvement in low contrast detectability for body AiCE.
    Noise Reduction ClaimDemonstrate noise reduction at the same dose for body AiCE compared to AIDR 3D.32% noise reduction at the same dose for body AiCE compared to AIDR 3D.
    Artifact Appearance ClaimNo introduction of additional artifacts and similar appearance to FBP and AIDR 3D for streak and beam hardening artifacts.Streak and beam hardening artifacts appeared the same with AiCE as when FBP and AIDR 3D were used and additional artifacts were not introduced.
    Spatial Resolution ClaimImproved high contrast spatial resolution of AIDR 3D with reduced noise for AiCE Body Sharp at 10% of the MTF.Twice the high contrast spatial resolution of AIDR 3D with reduced noise for AiCE Body Sharp at 10% of the MTF.
    Noise Appearance ClaimsAiCE noise appearance/texture should be:
    • More similar to high dose FBP (compared to FIRST);
    • More similar to FBP (compared to FIRST);
    • Improved (compared to FIRST);
    • More natural (compared to FIRST). | AiCE noise appearance/texture:
    • More similar to high dose filtered backprojection (compared to FIRST);
    • More similar to filtered backprojection (compared to FIRST);
    • Improved (compared to FIRST);
    • More natural (compared to FIRST). |
      | Clinical Image Quality | AiCE images for abdomen/pelvis, brain, inner ear, and extremity applications are of diagnostic quality. | Representative abdomen/pelvis, brain, inner ear and extremity AiCE images were confirmed to be of diagnostic quality by an American Board Certified Radiologist. |

    2. Sample Size Used for the Test Set and Data Provenance

    • Spectral Imaging Performance Testing - Bench: The sample size for phantoms used in bench testing is not specified beyond "various phantoms" and "Catphan and Body Phantom." Data provenance is laboratory bench testing.
    • Spectral Imaging Performance Testing - Clinical Images: The sample size is not specified beyond "Representative abdomen/pelvis, lung, and extremity Spectral Images." The data provenance of these clinical images (country of origin, retrospective/prospective) is not specified in the provided text.
    • Non-Spectral Imaging and AiCE Performance Testing - Bench: The sample size for phantoms used in bench testing is not specified beyond "various phantoms." Data provenance is laboratory bench testing.
    • AiCE Imaging Performance Testing - Clinical Images: The sample size is not specified beyond "Representative abdomen/pelvis, brain, inner ear and extremity AiCE images." The data provenance of these clinical images (country of origin, retrospective/prospective) is not specified in the provided text.

    3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

    • For both Spectral Imaging Clinical Images and AiCE Clinical Images: "an American Board Certified Radiologist" was used. This indicates one expert. The specific years of experience are not mentioned, but "American Board Certified" signifies a high level of qualification.

    4. Adjudication Method for the Test Set

    • For both Spectral Imaging Clinical Images and AiCE Clinical Images, only one expert (an American Board Certified Radiologist) reviewed the images. Therefore, there was no adjudication method between multiple experts employed for these clinical image quality assessments. The phrase "it was confirmed" implies a singular decision.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

    • No, a MRMC comparative effectiveness study was not explicitly mentioned in the provided text for evaluating human reader improvement with AI assistance. The clinical image reviews were done by a single radiologist to confirm "diagnostic quality" of the AI-processed images, not to compare human reader performance with and without AI. The quantitative performance (dose reduction, LCD improvement, noise reduction) was assessed via model observer evaluation or phantom studies.

    6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) was done

    • Yes, extensive standalone performance testing was done for both Spectral Imaging and AiCE.
      • Spectral Imaging: Bench testing utilizing phantoms assessed various image quality metrics (CNR, CT Number Accuracy, Uniformity, SSP, MTF-Wire, SD, NPS, LCD) to demonstrate substantial equivalence to the predicate. Other phantom studies supported claims of beam hardening artifact reduction and iodine concentration correlation.
      • AiCE: Bench testing utilizing phantoms assessed similar image quality metrics and pediatric phantom/protocol performance, demonstrating substantial equivalence. A model observer evaluation was specifically mentioned for quantitative assessments of dose reduction, LCD improvement, and noise reduction compared to FBP and AIDR 3D, which is a standalone algorithm-only performance assessment. Other phantom studies supported claims regarding artifact appearance, spatial resolution, and noise appearance/texture.

    7. The Type of Ground Truth Used

    • For Bench Testing (Spectral and AiCE): The ground truth was based on physical phantom measurements and known properties/compositions of the phantoms. For example, known concentrations of materials for iodine correlation, or predefined structures for MTF and LCD assessments.
    • For Clinical Image Reviews (Spectral and AiCE): The ground truth was expert consensus (single expert), specifically the judgment of an American Board Certified Radiologist that the images were of "diagnostic quality." This is a form of expert opinion or interpretation.

    8. The Sample Size for the Training Set

    • The document does not specify the sample size for the training set for either AiCE (Deep Convolutional Neural Network) or FIRST (Iterative Reconstruction Algorithm). It only mentions that AiCE employs "Deep Convolutional Neural Network methods."

    9. How the Ground Truth for the Training Set was Established

    • The document does not provide details on how the ground truth for the training set was established. It mentions the use of "Deep Convolutional Neural Network methods" for AiCE, which implies a supervised learning approach requiring labeled training data, but the specifics of that labeling process or who performed it are omitted.
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