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510(k) Data Aggregation

    K Number
    K240943
    Device Name
    LungVision
    Date Cleared
    2024-10-01

    (179 days)

    Product Code
    Regulation Number
    892.2050
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The LungVision System is intended to enable users to segment previously acquired 3D CT datasets and overlay and register these 3D segmented data sets with fluoroscopic live X-ray images of the same anatomy in order to support catheter/device navigation during pulmonary procedures.

    Device Description

    The Lung Vision System is designed to enable users to segment previously acquired 3D CT datasets and overlay and register these 3D segmented data sets with live X-ray images of the same anatomy in order to support catheter/device navigation during pulmonary procedures.

    The System is intended to assist the guidance of endobronchial tools to areas of interest inside a patient's lungs. The System allows the user to mark lesion locations and pathways to marked lesions using a patient's CT scan. During the endoscopic procedure, the System overlays planning information on real-time fluoroscopic images to guide endobronchial tool navigation. The System also provides tomographic images for lesion identification, as well as 3D views for understanding tool and lesion proximity and orientation. The System is designed to be integrated with fluoroscopic imaging systems and external displays.

    The Lung Vision system includes a main unit and a tablet. Image processing algorithms are executed on the main unit and the tablet is used as a primary method of interacting with the system.

    AI/ML Overview

    The provided text describes specific acceptance criteria and the studies conducted to demonstrate the subject device's performance.

    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance CriteriaReported Device Performance (Mean Accuracy ± STD)
    AI-Tomo Accuracy (Simulated cases)3.15 mm ± 3.2 mm (N=500)
    AI-Tomo Accuracy (Rigid body model cases)3.64 mm ± 1.57 mm (N=93)
    AI-Tomo Accuracy (CBCT scans cases)5.34 mm ± 3.32 mm (N=191)
    Lesion marking accuracy (AI-Tomo vs. CABT)Comparable

    2. Sample Size and Data Provenance for Test Set

    • Simulated Cases: 500 cases, based on "real human's CT scans," synthetically simulated.
    • Rigid Body Model Cases: 93 cases, using "only one lung anatomy." Data provenance is laboratory testing in a simulated environment.
    • CBCT Scans Cases: 191 cases, based on "real human's CT scans and real human's CBCT scans taken in real procedures." The images are CABTs collected from real cases performed by physicians using the LungVision system in the USA, Italy, and Israel. This represents retrospective real-world data.

    3. Number of Experts and Qualifications for Ground Truth Establishment

    The document mentions "clinical validation was performed by physicians" but does not specify the exact number of experts or their qualifications (e.g., years of experience, specific medical specialty).

    4. Adjudication Method for Test Set

    The document does not explicitly state an adjudication method (e.g., 2+1, 3+1). It states that the output (from AI-Tomo post-processing) is "evaluated using the ground truthing methodology." The ground truth methods are listed as "Geometry test" and "Lesion contrast on real data tests (with and without tool)," implying a direct comparison against a defined standard rather than an expert consensus adjudication protocol.

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

    The document states, "The clinical validation of AI Tomo confirmed that lesion marking accuracy was comparable when using CABT and AI Tomo images." This implies a comparison between human performance with CABT and human performance with AI-Tomo (assisted by physicians), but it does not explicitly detail an MRMC study comparing human readers with and without AI assistance (i.e., effect size of human improvement with AI assistance). It focuses on the comparison of the output of two imaging modalities for similar accuracy.

    6. Standalone (Algorithm Only) Performance

    Yes, standalone (algorithm only) performance was conducted for AI-Tomo. The accuracy metrics (mean accuracy and standard deviation) presented for simulated, rigid body model, and CBCT scan cases refer to the performance of the AI-Tomo algorithm itself in reconstructing images or guiding, based on input. The statement "The images are CABTs collected from real cases ... and the output is evaluated using the ground truthing methodology" further supports this, indicating the AI's output was evaluated against a ground truth.

    7. Type of Ground Truth Used

    The ground truth used includes:

    • Geometry test: This likely refers to a predefined geometric standard or measurement.
    • Lesion contrast on real data tests (with and without tool): This suggests evaluation of the AI's ability to delineate lesions and maintain contrast.
    • For the simulated and rigid body model cases, the ground truth would be precisely known due to the controlled nature of these environments (e.g., in simulated cases, the intended registration error, or in rigid body models, the pre-defined transform).
    • For CBCT cases, the ground truth methodology is stated, but the ultimate true "lesion location" reference is implied to be established through the "Geometry test" and "Lesion contrast" evaluations.

    8. Sample Size for Training Set

    The document does not specify the sample size for the training set used to develop the AI-Tomo feature. It mentions that "CABTs are used as input data to the AI-Tomo post processing," implying these real CABT cases were used for some phase of development or validation, but it doesn't separate training from testing data clearly in terms of counts.

    9. How Ground Truth for Training Set Was Established

    The document does not explicitly state how the ground truth for the training set was established. It describes ground truth methods for evaluation, but not specifically for the data used to train the AI model.

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    K Number
    K172955
    Device Name
    LungVision Tool
    Date Cleared
    2018-04-26

    (212 days)

    Product Code
    Regulation Number
    874.4680
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Lung Vision Tool is an instrument designed as a working channel intended to be used with standard bronchoscopes, endotherapy accessories and ultrasound probe to guide the endotherapy accessories or ultrasound probe to the target area, specifically within the respiratory system.

    Device Description

    Lung Vision Tool is an instrument designed as a working channel intended to be used with standard bronchoscopes, endo-therapy accessories and ultrasound probe to guide the endo-therapy accessories or ultrasound probe to the target area, specifically within the respiratory system.

    LungVision tool is designed to be used by pulmonologists or thoracic surgeons during pulmonary procedures.

    The LungVision Tool is designed to be connected to a standard Bronchoscope Instrument Port.

    The Lung Vision Bronchoscope Adaptor is used to connect the LungVision Handle to the Bronchoscope instrument port / working channel entrance, and to allow the physician to release the tool from the bronchoscope. The current adaptor is for the Olympus Bronchoscope Model BF-1T160.

    More types of Bronchoscope Adaptors for other bronchoscopy brands and models.

    Lung Vision Tool Sheath can accommodate endo-therapy accessories and ultrasound probes with an outer diameter up to 1.9 mm.

    AI/ML Overview

    The provided text describes the LungVision Tool, a medical device intended to be used with standard bronchoscopes, endotherapy accessories, and ultrasound probes to guide them to a target area within the respiratory system. The submission demonstrates substantial equivalence to predicate devices K060243 (Olympus Guide Sheath) and K151315 (Boston Scientific Expect™ Pulmonary Endobronchial Ultrasound Transbronchial Aspiration Needle).

    Here's an analysis of the acceptance criteria and the study information based on the provided text:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document doesn't explicitly state "acceptance criteria" in a tabulated format with numerical targets for each test, but it does list the tests performed and implies that the device "met all requirements specifications." The comparison table on pages 4 and 5 highlights the features and specifications for the predicate, reference, and subject device.

    Feature / Test CategoryPredicate K060243 (Olympus Guide Sheath)Reference K151315 (Boston EPEUTAN)Subject Device K172955 (LungVision Tool)Reported Performance (LungVision Tool)Acceptance Criteria (Implied)
    Intended UseGuide endo-therapy accessories/ultrasound probeGuide endo-therapy accessories/ultrasound probeGuide endo-therapy accessories/ultrasound probeSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Anatomical locationRespiratory organsRespiratory organsRespiratory organsSubstantially equivalent to predicateTo be substantially equivalent to predicate
    ComponentsHandle-like, Stopper, SheathHandle, Adaptor/Connector, Sheath, Wire/StyletHandle, Adaptor/Connector, Sheath, WireSimilar components to predicate/referenceTo be similar to predicate/reference
    Works with endo-therapy instrumentsYesYesYesYesYes
    ClassificationBronchoscope (flexible or rigid) and accessories. 21CFR 874.4680, Procut Code: EOQBronchoscope (flexible or rigid) and accessories. 21CFR 874.4680, Procut Code: EOQBronchoscope (flexible or rigid) and accessories. 21CFR 874.4680, Procut Code: EOQSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Target anatomyRespiratory OrgansRespiratory OrgansRespiratory OrgansSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Anatomy accessBronchial airwaysBronchial airwaysBronchial airwaysSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Patient PopulationNot specified (undergoing endoscopic procedures)Not specified (undergoing endoscopic procedures)Patients undergoing endoscopic proceduresSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Environment of useWhere endoscopic procedures performedWhere endoscopic procedures performedWhere endoscopic procedures performedSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Single UseYesYesYesYesYes
    SterileYesYesYesYesYes
    Mechanism of actionManual attachmentManual attachmentManual attachmentSubstantially equivalent to predicateTo be substantially equivalent to predicate
    Number of device passes during a procedureMultiple passesMultiple passesMultiple passesSubstantially equivalent to predicateTo be substantially equivalent to predicate
    X-ray detectionYesNoYesYes (similar to predicate)Yes
    Sheath Max Outer Diameter2.7 mmN/A2.72 mm2.72 mm (comparable to predicate)1.9 mm (to accommodate accessories)
    Working Length900 mmN/A1000 mm1000 mm (comparable to predicate)Sufficient for intended use
    BiocompatibilitySurface Contact Skin and Breached Limited duration (
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