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510(k) Data Aggregation

    K Number
    K984235
    Date Cleared
    1999-06-09

    (196 days)

    Product Code
    Regulation Number
    892.5730
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    INTERSOURCE 125, MODEL 1251L

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

    InterSource125 implants are indicated for interstitial implantation of select localized tumors with low to moderate radiosensitivity. They are used either as primary treatment for tumors such as those of the head, lung, neck, pancreas, prostate, and unresectable tumors, or for residual disease after excision of the primary tumor. InterSource125 implants are indicated for use concurrent with or at the completion of other treatment modalities, such as external beam radiation therapy.

    Device Description

    InterSource125 is a hermetically sealed radiotherapeutic source indicated for interstitial implantation. The radionuclide used in InterSource125 is Iodine-125 (I-125). InterSource125 is constructed by placing a platinum / iridium radiopaque marker and I-125 on the surface of a medical grade titanium inner tube. The device is sealed by sliding an outer tube, also medical grade titanium, over the inner tube and laser welding both ends. The resulting device has a hollow center with an inner diameter of 0.37 mm with all body tissue contacting surfaces made from medical grade titanium.

    AI/ML Overview

    The InterSource125 device, an Iodine-125 seed for brachytherapy, demonstrated substantial equivalence to its predicate device, the Amersham/Medi+Physics Model 6711 Therapeutic Seed Source, rather than a direct performance study against acceptance criteria from a standalone test. The assessment of substantial equivalence was based on a comparison of key characteristics.

    1. Table of Acceptance Criteria and Reported Device Performance

    As this is a substantial equivalence submission, direct "acceptance criteria" as would be seen in a performance study with defined thresholds for metrics like sensitivity or specificity are not present. Instead, the "acceptance criteria" are implied by the similarity to the predicate device's characteristics. The "reported device performance" is the InterSource125's characteristics and its computed radiation distribution compared to the predicate's known characteristics and measured radiation distribution.

    Feature DescriptionAcceptance Criteria (Predicate Device)Reported Device Performance (InterSource125)Basis of Equivalence
    Indications for UseFor interstitial treatment of tumors with specific characteristics (unresectable, localized, slow growth rate, low to moderate radiosensitivity).Interstitial implantation of select localized tumors with low to moderate radiosensitivity. Used as primary treatment or for residual disease after excision. Used concurrently or after other modalities like external beam radiation therapy.Indication statements were compared and found to be substantially equivalent in intent.
    Physical SizeLength: 4.5 mm, Outside Diameter: 0.8 mm (Outer Tube)Length: 4.5 mm, Outside Diameter: 0.8 mm (Outer Tube)Identical dimensions.
    Radiopaque MarkerSilverPlatinum / IridiumBoth devices incorporate a radiopaque marker. The material difference was assessed as not affecting equivalence.
    BiocompatibilityTitanium (Outer Tube), Silver (Isotope Carrier)Medical grade titanium (Outer Tube, Inner Tube, Isotope Carrier)Both use known biocompatible materials. Titanium is specified for all body-tissue contacting surfaces in InterSource125.
    RadioisotopeIodine-125Iodine-125Identical radioisotope.
    Half-life59.4 days59.4 daysIdentical.
    Principal Energy Levels27.2 keV, 27.5 keV, 31.0 keV, 35.5 keV27.2 keV, 27.5 keV, 31.0 keV, 35.5 keVIdentical.
    Distribution of IsotopeDeposited onto the surface of the isotope carrierDeposited onto the surface of the isotope carrierIdentical method.
    Apparent Activity Levels0.18 to 5.99 mCi0.1 to 5.0 mCiComparable range, with InterSource125's range falling largely within or closely to the predicate's.
    Residual Activity
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    K Number
    K973328
    Device Name
    INTERSOURCE
    Date Cleared
    1998-12-10

    (462 days)

    Product Code
    Regulation Number
    892.5730
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    INTERSOURCE

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

    InterSeed™ implants are indicated for interstitial implantation of select localized tumors with low to moderate radiosensitivity. They are used either as primary treatment for tumors such as those of the head, lung, neck, pancreas, prostate, and unresectable tumors, or for residual disease after excision of the primary tumor. InterSeed™ implants are indicated for use concurrent with or at the completion of other treatment modalities, such as external beam radiation therapy.

    Device Description

    InterSeed™ is an hermetically sealed radiotherapeutic source indicated for interstitial implantation. The radionuclide used in InterSeed™ is Palladium 103 (Pd-103). InterSeed™ is constructed by placing a platinum radiopaque marker and Pd-103 on the surface of a medical grade titanium inner tube. The device is sealed by sliding an outer tube, also medical grade titanium, over the inner tube and laser welding both ends. The resulting device has a hollow center with an inner diameter of 0.35 mm with all body tissue contacting surfaces made from medical grade titanium.

    AI/ML Overview

    The provided text describes the InterSeed™ device, a radiotherapeutic source for interstitial implantation, and compares it to a predicate device, the Modified Palladium Seed Model 100, to demonstrate substantial equivalence for regulatory clearance. This is not a study proving device performance against acceptance criteria in the typical sense of a clinical trial or algorithm performance study. Instead, it's a regulatory submission demonstrating equivalence to an already approved device.

    However, I can extract the information and frame it as acceptance criteria and reported device performance based on the provided document's structure for the purpose of your request.

    Here's the breakdown of the information you requested, based on the provided document:

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

    Since this is a substantial equivalence submission, the "acceptance criteria" are the features and performance of the predicate device, and the "reported device performance" is the InterSeed™ device's corresponding features and performance. The goal is to show they are "substantially equivalent."

    Feature/Acceptance Criteria (Predicate Device)Reported Device Performance (InterSeed™)Assessment (Acceptance Met)
    Indications: Interstitial implantation for localized, unresectable, low to moderate radiosensitivity tumors (e.g., superficial, intrathoracic, intraabdominal, lung, pancreas, prostate [stage A or B], residual following XRT, recurrent).Indications: Interstitial implantation of select localized tumors with low to moderate radiosensitivity (e.g., head, lung, neck, pancreas, prostate, unresectable tumors, or residual disease after excision). Used concurrent with or at completion of other treatment modalities (e.g., external beam radiation therapy).Met (Substantially Equivalent)
    Physical Size (Outer Tube Length): 4.5 mmPhysical Size (Outer Tube Length): 4.5 mmMet (Same)
    Physical Size (Outer Tube Diameter): 0.81 mmPhysical Size (Outer Tube Diameter): 0.81 mmMet (Same)
    Radiopaque Marker: LeadRadiopaque Marker: PlatinumMet (Both have a radiopaque marker)
    Radioisotope: Palladium 103Radioisotope: Palladium 103Met (Same)
    Half-life: 17 daysHalf-life: 17 daysMet (Same)
    Principal Energy Levels: 20.1 keV, 20.2 keV, 22.7 keV, 23.2 keVPrincipal Energy Levels: 20.1 keV, 20.2 keV, 22.7 keV, 23.2 keVMet (Same)
    Apparent Activity Levels: 0.5 to 5.0 mCiApparent Activity Levels: 0.5 to 5.0 mCiMet (Same)
    Residual Activity:
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