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The DigiX FDX radiographic systems are used in hospitals, clinics and medical practices. DigiX FDX enables radiographic exposure of the whole body including: Skull, chest, abdomen, and extremities and may be used on pediatric, adult and bariatric patients. It can also be used for intravenous, small interventions (like biopsy, punctures, etc.) and emergency (trauma critical ill) applications.

Exposure may be taken with the Patient's sitting, standing, or in the prone/supine position.

The DigiX FDX System is not meant for mammography.

The DigiX FDX uses an integrated or portable or fixed or wi-fi digital detector for generating diagnostic images by converting X-Ray into electronics signals. DigiX FDX is also designed to be used with conventional film/screen or Computed Radiography (CR) Cassettes.

The DigiX FDX system is a diagnostic X-Ray system intended for general purpose radiographic imaging of the human body. It is not intended for mammographic imaging.

The DigiX FDX system is comprised of a combination of devices that include a ceiling mounted X-Ray tube suspension, vertical Bucky stand, fixed or mobile patient Bucky table, X-Ray generator, X-Ray tube, beam limiting device, and a solid-state image receptor.

The DigiX FDX systems are not intended to be operated with any other cleared devices, or to be integrated with other software/hardware devices via direct or indirect connections.

The provided FDA 510(k) summary for the DigiX FDX device details its substantial equivalence to predicate devices, particularly focusing on technical and functional similarities rather than a standalone performance study with specific acceptance criteria related to diagnostic accuracy. Therefore, the response will focus on the details available within the document regarding non-clinical testing and conformity to standards, as a direct "acceptance criteria vs. reported performance" table for diagnostic metrics is not present.

Here's a breakdown of the requested information based on the provided text:

1. A table of acceptance criteria and the reported device performance

The document does not present specific acceptance criteria in terms of diagnostic performance metrics (e.g., sensitivity, specificity for a particular condition) and a corresponding reported device performance with numerical results. Instead, the acceptance criteria are framed in terms of:

• Conformity to recognized standards: The device must comply with various IEC and ISO standards related to electrical safety, electromagnetic compatibility, radiation protection, software life cycle, usability, and risk management.
• Meeting design requirements: Non-clinical verification testing ensures the device's functions and image performance meet its design specifications.
• Substantial equivalence: The primary "acceptance criterion" for this 510(k) submission is to demonstrate substantial equivalence to the predicate devices (DigiX FDX K192541 and Siemens Ysio K081722) without raising new questions of safety or effectiveness.

2. Sample size used for the test set and the data provenance

The document explicitly states: "No clinical data is necessary to evaluate safety or effectiveness for purposes of determining substantial equivalence of the proposed device. Hence, clinical testing is not applicable due to the fact that no new clinical applications were introduced to the system. Bench testing was performed to assess the device safety and effectiveness."

Therefore, there was no "test set" in the sense of patient images or clinical data used for this 510(k) submission to prove diagnostic performance. The testing was non-clinical (bench testing, verification, and validation) and focused on engineering criteria, safety, and functionality.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable, as no clinical test set requiring expert ground truth was used for this submission.

4. Adjudication method for the test set

Not applicable, as no clinical test set requiring adjudication was used for this submission.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. The DigiX FDX is an X-ray imaging system, not an AI-assisted diagnostic device for image interpretation. Its changes primarily involve hardware components (new detectors) and software GUI updates.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This device is an X-ray system, not a standalone diagnostic algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

Not applicable in the context of diagnostic ground truth. For the non-clinical testing performed, the "ground truth" would be established by engineering specifications, recognized standards, and established testing methodologies for hardware and software functionality and safety.

8. The sample size for the training set

Not applicable. This is not an AI/machine learning device that requires a training set for diagnostic classification.

9. How the ground truth for the training set was established

Not applicable.

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The DigiX FDX radiographic systems are used in hospitals, clinics and medical practices. DigiX FDX enables radiographic exposure of the whole body including: Skull, chest, abdomen, and extremities and may be used on pediatric, adult and bariatic patients. It can also be used for intravenous, small interventions (like biopsy, punctures, etc.) and emergency (trauma critical ill) applications. Exposure may be taken with the Patient's sitting, standing, or in the prone/ supine position.

The DigiX FDX System is not meant for mammography.

The DigiX FDX uses an integrated or portable or fixed or wi-fi digital detector for generating diagnostic images by converting X-Ray into electronics signals. DigiX FDX is also designed to be used with conventional film/screen or Computed Radiography (CR) Cassettes.

The DigiX FDX system is a diagnostic X-Ray system intended for general purpose radiographic imaging of the human body. It is not intended for mammographic imaqing.

The DigiX FDX system is comprised of a combination of devices that include a ceiling mounted X-Ray tube suspension, vertical Bucky stand, fixed or mobile patient Bucky table, X-Ray generator, X-Ray tube, beam limiting device, and a solid-state image receptor.

The DigiX FDX systems are not intended to be operated with any other cleared devices, or to be integrated with other software/hardware devices via direct or indirect connections.

Here's a breakdown of the acceptance criteria and study information based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

The document focuses on demonstrating substantial equivalence to predicate devices rather than defining specific quantitative performance metrics as "acceptance criteria" for a new AI/software feature in the way clinical performance studies usually do. Instead, the "acceptance criteria" are implied to be that the modifications do not negatively impact safety or effectiveness, and that the device performs comparably to the predicate devices and meets relevant safety standards.

For the new features explicitly mentioned (Automatic Stitching and Dual Energy Subtraction), the document states they add functionality without affecting patient safety or effectiveness. For the other components, the criteria are often "Same" or "Similar functionality with same imaging results" or "doesn't affect the safety or effectiveness."

To represent this in a table, we'll extract performance comparisons from the "Functional and Specification Differences" table (Table 4) and the "Justification for Differences" (Table 5).

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

The document states:

• "Non-clinical testing included verification and validation testing, image evaluation, testing, and safety testing."
• "Performance testing included functional testing of all motions of the system(s) with respect to the design specifications. Image performance testing was conducted and results included in the submission."
• "Clinical testing is not applicable due to the fact that no new clinical applications were introduced to the system."

The document does NOT specify a sample size for any test set (clinical or otherwise) in terms of patient data or images used for validation of the radiographic system itself, nor does it mention data provenance (country of origin, retrospective/prospective). It primarily relies on hardware and software equivalence, and compliance with industry standards.

3. Number of Experts Used to Establish Ground Truth and Qualifications

Not applicable. The document explicitly states "Clinical testing is not applicable." Therefore, there was no clinical study conducted that would necessitate expert readers to establish ground truth for a test set. The evaluation focuses on technical performance and equivalence to predicate devices.

4. Adjudication Method for the Test Set

Not applicable. As no clinical test set requiring expert adjudication was performed, no adjudication method is mentioned.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No MRMC comparative effectiveness study was done. The document states "Clinical testing is not applicable due to the fact that no new clinical applications were introduced to the system." Therefore, there is no information on how much human readers improve with or without AI assistance. The new software features (Automatic Stitching, Dual Energy Subtraction) are presented as additional functionalities that don't affect safety or effectiveness, not as AI-assisted diagnostic tools requiring a comparative effectiveness study.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

Not applicable. The device is a radiographic system, not an AI algorithm intended for standalone diagnostic performance. While it includes new software features (Automatic Stitching, Dual Energy Subtraction), these are integrated functionalities of the imaging system and not described as standalone diagnostic algorithms requiring independent performance evaluation without human interaction.

7. Type of Ground Truth Used

The "ground truth" for the evaluation is primarily based on:

• Compliance with technical specifications and design requirements: Functional testing, image performance testing.
• Adherence to safety and performance standards: IEC 60601 series, EN ISO 14971, IEC 62366-1, IEC 62304, 21 CFR 1020.30, 21 CFR 1020.31.
• Substantial equivalence to predicate devices: Demonstration that the new device has the same intended use, fundamental technological characteristics, and that any differences do not raise new questions of safety or effectiveness.
• Software documentation assessment: For the software components, including the new features, documentation was provided for a "Moderate Level of Concern" software as per FDA guidance.

No clinical ground truth (e.g., expert consensus, pathology, outcomes data) was used or required given the nature of this submission.

8. Sample Size for the Training Set

Not applicable. The document describes an X-ray imaging system, not an AI/ML device that requires a training set of data. The new software features (Automatic Stitching, Dual Energy Subtraction) are described as functionalities, not adaptive algorithms that learn from data.

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

Not applicable. As there was no training set, there was no ground truth to establish for it.

Ask a specific question about this device

The DigiX FDX radiographic systems are used in hospitals, clinics and medical practices. DigiX FDX enables radiographic exposure of the whole body including: Skull, chest, abdomen, and extremities and may be used on pediatric, adult and bariatric patients. It can also be used for intravenous, small interventions (like biopsy, punctures, etc.) and emergency (trauma critical ill) applications. Exposure may be taken with the Patient's sitting, standing, or in the prone position. The DigiX FDX System is not meant for mammography. The DigiX FDX uses an integrated or portable or fixed or wi-fi digital detector for generating diagnostic images by converting X-Ray into electronics signals. DigiX FDX is also designed to be used with conventional film/screen or Computed Radiography (CR) Cassettes.

The DigiX FDX system is a diagnostic x-ray system intended for general purpose radiographic imaging of the human body. It is not intended for mammographic imaging. The DigiX FDX system is comprised of a combination of devices that include a ceiling mounted x-ray tube suspension, vertical Bucky stand, fixed or mobile patient Bucky table, x-ray generator, x-ray tube, beam limiting device, and a solid-state image receptor. The DigiX FDX systems are not intended to be operated with any other cleared devices, or to be integrated with other software/hardware devices via direct or indirect connections.

Here's a summary of the acceptance criteria and the study information for the Allengers Medical Systems Limited DigiX FDX device, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance:

The document primarily focuses on substantial equivalence to a predicate device (Siemens Ysio K081722) rather than defining explicit, quantitative acceptance criteria for clinical performance. The "acceptance criteria" can be inferred as meeting or being sufficiently similar to the predicate device in terms of functionality and safety, as well as complying with relevant standards.

• G1092: 0.6mm/1.2mm focal spot (Predicate: 0.6mm/1.0mm), 1 MHU (Predicate: 783 kHU), 108 mm target diameter (Predicate: 100 mm).
  G292: 0.6mm/1.2mm focal spot (Predicate: 0.6mm/1.0mm), 600 KHU (Same), 12° target angle (Predicate: 16°), 102 mm target diameter (Predicate: 100 mm). | Similar, providing essentially same imaging resolution and higher loading for some G1092 models. Different target angle for G292 provides full coverage at 40" SID. Differences in heat units and target diameter also noted as "similar" or providing higher loading/instantaneous focal spot loading. |
  | Beam Limiting Device: Construction, compliance with CFR 21 1020.31, automatic feature. | Matches predicate. | Same. |
  | Solid State X-ray Image Detectors: Panel type, active area, pixel pitch, pixel matrix, input scintillator, limiting resolution. | Detectors (e.g., P-E XRPAD 4343F vs. Trixell Pixium 4600):
• Active area: 432x432mm (Predicate: 429x429mm).
• Pixel pitch: 100 µm (Predicate: 143 µm).
• Pixel matrix: 4318x4320 (Predicate: 3001x3001).
• Limiting resolution: 5 lp/mm (Predicate: 3.57 lp/mm).
  Similar differences for other detector models listed. | Essentially the same imaging area. Provides higher resolution for pixel pitch, pixel matrix, and limiting resolution in most cases, which is considered an improvement and not negatively affecting safety or effectiveness. |
  | Viewing Monitors: Size, resolution. | Matches predicate. | Same. |
  | Software Features: DICOM 3.0 compatibility, operating system, user interaction, multi-user, image import/export, acquisition device, image interferences, organization, search, storage, database, viewing, measurement, annotation, operations, security, generator control. | Matches predicate for all listed software features. Also uses previously cleared image processing software. | Same. |
  | Safety Standards Compliance: | Complies with 21 CFR 1020.30, 21 CFR 1020.31, IEC 60601-1, EN 60601-1-2, IEC 60601-1-3, IEC 60601-2-54, EN ISO 14971, EN 62366, EN 62304. | All applicable standards met. |
  | Functional Performance: All system motions, image performance. | All functions met design requirements. Image performance criteria satisfactorily met (details in Section 18 of the original submission, not provided in this extract). | Confirmed. |
  | Software/Firmware Functionality: All functions between DROC software and IntegraX firmware. | All functions passed testing criteria. | Confirmed. |

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

The document explicitly states: "It was determined that clinical evaluation was not required as all imaging devices have been previously cleared by the FDA."
Therefore, there was no clinical test set used for this specific 510(k) submission. The evaluation was based on non-clinical testing and substantial equivalence to previously cleared devices.

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

Not applicable, as no clinical test set requiring expert ground truth was used.

4. Adjudication Method for the Test Set:

Not applicable, as no clinical test set requiring adjudication was used.

5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

Not applicable. The device is a diagnostic X-ray system, not an AI-powered diagnostic tool, and no MRMC study was conducted.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

Not applicable. The device is a diagnostic X-ray system, not an algorithm, and its performance is evaluated as a system used by a human operator.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

Not applicable for clinical ground truth, as no clinical evaluation was performed. For non-clinical performance (image quality, functional testing, safety), the "ground truth" was compliance with design specifications and relevant international standards.

8. The sample size for the training set:

The document does not describe the use of machine learning or AI models that would require a "training set" in the traditional sense. The device is a traditional X-ray system. The component parts, such as solid-state detectors and image processing software, are stated to have been "previously cleared by the FDA" or "tested and evaluated per Guidance for the Submission of 510(k)s for Solid State X-ray Imaging Devices." Therefore, any implicit training (e.g., for image processing algorithms) would have occurred as part of the development and clearance of those component devices, but details are not provided here for the system submission.

9. How the ground truth for the training set was established:

Not applicable, as no training set for an AI/ML model is described for this device.

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