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510(k) Data Aggregation
(29 days)
The Discovery XR656 HD is intended to generate digital radiographic images of the skull, spinal column, chest, abdomen. extremities, and other body parts in patients of all ages. Applications can be performed with the patient sitting, standing. or lying in the prone or supine position and the system is intended for use in all routine radiography exams. Optional image pasting function enables the operator to stitch sequentially acquired radiographs into a single image.
The Discovery XR656 HD incorporates AutoGrid, which is an optional image processing software installed as a part of the systems Helix image processing software. AutoGrid can be used in lieu of an anti-scatter grid to improve image contrast in general radiographic images by reducing the effects of scatter radiation.
When the VolumeRAD option is included on the system can generate tomographic images of human anatomy including the skull, spinal column, chest, abdomen, extremities, and other body parts in patients of all ages.
When the VolumeRAD option is used for patients undergoing thoracic imaging, it is indicated for the detection of lung nodules. VolumeRad generates diagnostic images of the radiologist in achieving superior detectability of lung nodules versus posterior and left lateral views of the chest, at a comparable radiation level.
The device is not intended for mammographic applications.
The Discovery XR656 HD Radiography X-ray System is designed as a modular system with components that include an Overhead Tube Suspension with tube/collimator, wallstand, Table, X-ray generator, and cleared wireless digital detectors. The list of detectors verified and validated for use with the Discovery XR656 HD system, including their specifications, are provided in the user documentation. The System generates diagnostic radiographic images which can be sent through a DICOM network for applications including printing, viewing, and storage.
The components may be combined in different configurations to meet specific customer needs. In addition, upgrade configurations are available for predicate devices.
The optional image pasting function enables the operator to stitch sequentially acquired radiographs into a single image.
This 510(k) is to incorporate the VolumeRad advanced application that was currently available on the Discovery XR656 product onto the Discovery XR656 HD, as well as introduce a new Metal Artifact Reduction Algorithm, and an optional standalone console to take any Helix™ acquired images via DICOM (such as from a Discovery XR656 HD, Optima XR646 HD, or Optima XR240amx) and process the images independently of the system it was acquired on.
This document is a 510(k) Premarket Notification submission for the GE Healthcare Discovery XR656 HD with VolumeRad. The submission details the device's technical characteristics, intended use, and a comparison to predicate and reference devices to establish substantial equivalence.
Based on the provided text, the device itself (Discovery XR656 HD with VolumeRad) is an X-ray system, not an AI or algorithm. Therefore, the questions related to AI performance metrics such as reader improvement with AI assistance, standalone algorithm performance, and sample sizes for training/test sets specifically for an AI component are not directly applicable.
However, the document does describe the "Metal Artifact Reduction algorithm for VolumeRad" and mentions its evaluation. This suggests an algorithmic component, though not an AI in the common sense of machine learning for diagnosis. The data provided focuses on demonstrating substantial equivalence to predicate devices for the overall system and its features, including the VolumeRad function with updated detectors and the metal artifact reduction algorithm.
Here's an analysis based on the information available, addressing the relevant points:
1. Table of Acceptance Criteria and Reported Device Performance:
The document primarily focuses on establishing substantial equivalence for the Discovery XR656 HD with VolumeRad to predicate devices, rather than defining specific acceptance criteria for a new AI algorithm and reporting its performance against those. The "performance" discussed is related to the overall system's safety and effectiveness, and the ability of the VolumeRad feature to generate diagnostic images comparable to or better than traditional views for lung nodule detection.
The statement regarding VolumeRad: "VolumeRad generates diagnostic images of the radiologist in achieving superior detectability of lung nodules versus posterior and left lateral views of the chest, at a comparable radiation level." acts as a performance claim for the VolumeRad feature itself, which is part of the device.
| Acceptance Criteria (Implied for VolumeRad feature) | Reported Device Performance (for VolumeRad) |
|---|---|
| Aid radiologist in achieving superior detectability of lung nodules | Generates diagnostic images that aid the radiologist in achieving superior detectability of lung nodules. |
| Comparable radiation level to posterior-anterior and left lateral views | Achieves this superior detectability at a comparable radiation level to posterior-anterior and left lateral views. |
| Reduce ripple and ghost metal artifacts (for MAR algorithm) | Bench testing using anthropomorphic phantoms was sufficient to provide evidence that it can reduce the ripple and ghost metal artifacts. |
2. Sample Size Used for the Test Set and Data Provenance:
- Test Set for VolumeRad feature and Metal Artifact Reduction Algorithm: The document states that "bench testing using anthropomorphic phantoms was sufficient" for evaluating the Metal Artifact Reduction algorithm and for showing the equivalence of the VolumeRad feature with updated resolution detectors.
- Sample Size: Not explicitly stated as a number of cases or patients from a clinical study for the test set. It refers to "anthropomorphic phantoms."
- Data Provenance: Not human clinical data. The data originates from "anthropomorphic phantoms" used in bench testing. Given it's a GE Healthcare product, typically such testing occurs internally or at partner facilities. The location of the manufacturer is China.
- Retrospective/Prospective: Not applicable as it's bench testing with phantoms.
3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications:
- Since the testing was primarily bench testing with anthropomorphic phantoms, there is no mention of human experts establishing ground truth in the context of reading images from a test set. Evaluation would likely involve technical measurements and visual assessment by product development engineers or possibly consulting radiologists for image quality, but this isn't described as a formal ground truth process for a clinical test set.
4. Adjudication Method for the Test Set:
- Not applicable, as the evaluation was primarily bench testing with phantoms.
5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:
- No, a multi-reader multi-case (MRMC) comparative effectiveness study comparing human readers with and without AI assistance was not done. The submission explicitly states: "The subject of this premarket submission, Discovery XR656 HD with VolumeRad, did not require clinical studies to support substantial equivalence for the changes identified."
- Effect Size: Not determined, as no such study was performed.
6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study:
- The document implies that the fundamental algorithm to create the VolumeRad image set is identical to the algorithm cleared under K132261. The Metal Artifact Reduction algorithm was evaluated via bench testing. While these are algorithmic components, the overall "device" is an X-ray system. The performance claims for VolumeRad are implicitly related to its ability to present images that aid the radiologist (human-in-the-loop). Bench testing of the algorithms was done, but not as a standalone diagnostic AI performance study in the typical sense for clinical claims.
7. Type of Ground Truth Used:
- For the technical evaluation of the VolumeRad feature and the Metal Artifact Reduction algorithm, the "ground truth" was established through bench testing using anthropomorphic phantoms. This means known conditions (e.g., presence/absence of nodules, specific metal artifacts) were simulated in the phantoms to assess the system's output.
8. Sample Size for the Training Set:
- The document does not describe the development of a new AI algorithm that would typically involve a "training set." The VolumeRad algorithm is stated to be "identical" to a previously cleared algorithm. The Metal Artifact Reduction algorithm is new, but its development process (including any training data if it were a machine learning algorithm) is not detailed. Therefore, the sample size for a training set is not provided.
9. How the Ground Truth for the Training Set Was Established:
- Not applicable as no specific "training set" for a new AI algorithm is described. For the general development of the overall system and its included algorithms, ground truth would be established through engineering specifications, phantom studies for image quality, and comparison against known physical properties.
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(30 days)
The Discovery XR656 HD is intended to generate digital radiographic images of the skull, spinal column, chest, abdomen, extremities, and other body parts in patients of all ages. Applications can be performed with the patient sitting, standing, or lying in the prone or supine position and the system is intended for use in all routine radiography exams. Optional image pasting function enables the operator to stitch sequentially acquired radiographs into a single image.
The device is not intended for mammographic applications.
The Discovery XR656 HD Radiography X-ray System is designed as a modular system with components that include an Overhead Tube Suspension with tube/collimator, wallstand, Table, X-ray generator, and wireless digital detectors. The System generates diagnostic radiographic images which can be sent through a DICOM network for applications including printing, viewing, and storage. The components may be combined in different configurations to meet specific customer needs. In addition, upgrade configurations are available for predicate devices. The optional image pasting function enables the operator to stitch sequentially acquired radiographs into a single image.
The provided text describes a 510(k) premarket notification for the GE HUALUN MEDICAL SYSTEMS CO. Ltd. Discovery XR656 HD (K172869), a digital radiographic X-ray system. The document focuses on demonstrating substantial equivalence to a predicate device (Optima XR646, K143270) rather than presenting a performance study with detailed acceptance criteria and clinical efficacy results for the entire system.
The core of the submission revolves around the change in detector technology from Ultra Wideband (UWB) to WiFi (802.11) for image transfer, utilizing cleared detectors (PerkinElmer XRpad2 3025 HWC-M Flat Panel Detector, K161942, and PerkinElmer XRpad2 4336 HWC-M Flat Panel Detector, K161966).
Here's an breakdown of the information requested, based on the provided text:
1. A table of acceptance criteria and the reported device performance
The document does not explicitly state quantitative acceptance criteria or specific performance metrics (e.g., sensitivity, specificity, accuracy) for the Discovery XR656 HD as a standalone diagnostic tool. Instead, it relies on demonstrating compliance with recognized standards and successful design verification and validation testing to ensure that the modifications (primarily the change to WiFi-enabled detectors) do not negatively impact the device's safety and effectiveness compared to the predicate.
The "Summary of Non-Clinical Tests" section mentions compliance with several voluntary standards. While these standards implicitly contain performance requirements, the specific numerical acceptance criteria for those requirements and the actual measured performance of the Discovery XR656 HD are not detailed in this summary.
| Acceptance Criteria (Inferred from Compliance and EQUIVALENCE claims) | Reported Device Performance (as stated in summary) |
|---|---|
| Compliance with ES60601-1 (Basic safety and essential performance) | Device and its applications comply with ES60601-1. |
| Compliance with IEC 60601-1-2 (Electromagnetic Compatibility) | Device and its applications comply with IEC 60601-1-2. |
| Compliance with IEC 60601-1-3 (Radiation Protection) | Device and its applications comply with IEC 60601-1-3. |
| Compliance with IEC 60601-1-6 (Usability) | Device and its applications comply with IEC 60601-1-6. |
| Compliance with IEC 60601-2-54 (X-ray equipment for radiography and radioscopy) | Device and its applications comply with IEC 60601-2-54. |
| Compliance with IEC 62366 (Application of usability engineering) | Device and its applications comply with IEC 62366. |
| Compliance with PS 3.1 - 3.20 DICOM set | Device and its applications comply with PS 3.1 - 3.20 DICOM set. |
| Mitigation of risks identified for wireless image transfer | Risks were reviewed and mitigated with design controls and labeling. Mitigations were verified and validated with acceptable results. |
| Safety and effectiveness not affected by modifications | Design verification and validation testing performed confirmed that safety and effectiveness have not been affected. |
| No new potential safety risks | This update to the system does not result in any new potential safety risks. |
| Same technological characteristics as predicate | Has the same technological characteristics. |
| Performs as well as predicate devices | Performs as well as the devices currently on the market. |
| Safe, effective, and substantially equivalent to predicate devices | After analyzing design verification and validation testing, it is concluded that the Discovery XR656 HD is as safe, as effective, and performance is substantially equivalent to the predicate devices. |
2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)
The document states, "The subject of this premarket submission, Discovery XR656 HD, did not require clinical studies to support substantial equivalence for the incorporation WiFi (802.11) enabled detectors due to these detectors having their own 510(k) clearance."
Therefore, for the Discovery XR656 HD itself, there was no specific clinical "test set" and corresponding sample size for demonstrating diagnostic performance beyond its cleared components. The evaluation focused on non-clinical design verification and validation. The "testing/documentation" mentioned was "according to... FDA guidance documents" (for software and cybersecurity), and these were "bench" tests.
The cleared detectors (PerkinElmer XRpad2 3025 HWC-M and 4336 HWC-M) would have had their own clinical data for their respective 510(k) clearances (K161942 and K161966), but that data is not provided here for the Discovery XR656 HD system.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)
Since no clinical studies were performed for the Discovery XR656 HD's diagnostic performance, there was no test set requiring expert-established ground truth in the context of diagnostic accuracy. The ground truth for the training of the system's image processing (if applicable, which falls under "image processing algorithms to accommodate multiple image matrix sizes") is not detailed here.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
Not applicable as no clinical test set for diagnostic performance was conducted 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. This device is a digital radiographic X-ray system, not an AI-assisted diagnostic tool in the sense of providing automated readings or decision support. The "image processing algorithms" mentioned are for accommodating different image matrix sizes and are not described as AI for diagnostic assistance. There is no mention of an MRMC study or AI assistance.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
Not applicable. This is a medical imaging system, not a standalone algorithm. The "image processing algorithms" are integrated into the system, and their performance is evaluated as part of the overall system's technical validity, not as a standalone diagnostic algorithm.
7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)
As no clinical study for diagnostic performance was required or conducted for this 510(k) submission, the concept of "ground truth" (in the diagnostic sense) for this specific submission is not present. The "ground truth" for the system's functionality was established through design verification and validation testing against engineering specifications and industry standards.
8. The sample size for the training set
The document does not specify a training set sample size. While "image processing algorithms" are mentioned, implying potential machine learning components, no details on their training are provided. The focus of the submission is on hardware and communication changes, and the safety and effectiveness of the system with these changes.
9. How the ground truth for the training set was established
Not applicable. No information is provided about a training set or its ground truth establishment.
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