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510(k) Data Aggregation

    K Number
    K172848
    Date Cleared
    2017-12-27

    (99 days)

    Product Code
    Regulation Number
    892.5050
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    MEVION S250i Proton Beam Radiation Therapy Device

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

    The MEVION S250i is intended to deliver proton radiation therapy treatment to patients with localized tumors or other conditions susceptible to treatment by radiation.

    Device Description

    The MEVION S250i is a proton beam radiation therapy system, which provides a therapeutic proton beam for clinical treatment. It is designed to deliver a proton beam with the prescribed dose and dose distribution to the prescribed patient treatment site. The MEVON S250i is a modern proton therapy system combining a patented, gantry-mounted proton source and a precision scanning beamline with a highly integrated, image-based workflow. The proton accelerator is a superconducting synchrocyclotron. The synchrocyclotron source generates protons of energy 230 MeV and is mounted in a high-precision concentric gantry system that rotates and points at treatment isocenter at all times. The system components include a Beam Generation System, Beam Delivery System, Structural Support and Alignment System, Patient Positioning System, Control System Software, and a Hard-wired Safety System (HSS).

    AI/ML Overview

    This document is a 510(k) summary for the Mevion S250i, a proton radiation beam therapy system. It focuses on demonstrating substantial equivalence to predicate devices rather than proving device performance against specific acceptance criteria through a clinical study. Therefore, much of the requested information about acceptance criteria, study details, and ground truth cannot be extracted directly from this document.

    However, based on the provided text, I can infer some aspects related to acceptance criteria and the methods used to validate the device's substantial equivalence.

    Here's a breakdown of the requested information, with disclaimers where the information is not explicitly provided:

    1. Table of Acceptance Criteria and Reported Device Performance

    The document does not present a formal table of "acceptance criteria" in the sense of predefined performance targets for a clinical study. Instead, it compares the technological characteristics of the MEVION S250i (Applicant Device) with two predicate devices. The implicit "acceptance criterion" for this 510(k) submission is that the technological characteristics of the MEVION S250i are "Substantially Equivalent" to the predicate devices and that there are "no new or different issues of safety or efficacy."

    The table below summarizes the key technical characteristics provided in the document for comparison:

    CharacteristicAcceptance Criteria (Predicate Device K152224/K120676 Values)Reported Device Performance (MEVION S250i)
    Intended UseDeliver proton radiation treatment to patients with localized tumors or conditions susceptible to treatment by radiation.Identical.
    Energy (MeV) at Patient70-230 MeV (IBA Proteus One), 70-250 MeV (MEVION S-250)70-230 MeV
    ParticleProtonProton
    Accelerator230 MeV superconducting synchrocyclotron (IBA), 250 MeV superconducting synchrocyclotron (MEVION S-250)230 MeV superconducting synchrocyclotron
    Beam Time StructurePulsed Beam at 1000 Hz (IBA), Pulsed Beam at 500 Hz (MEVION S-250)Pulsed Beam at 750 Hz
    Ion SourceCold Cathode PIG Ion SourceCold Cathode PIG Ion Source
    Type of CoilsSuperconducting CoilsSuperconducting Coils
    Cooling MethodChilled water and Gifford-McMahon CryocoolersChilled water and Gifford-McMahon Cryocoolers
    Beam Transport and Switching SystemBeam transport system from dedicated cyclotron vault (IBA); No beam switching/transport (MEVION S-250)No beam switching or transport system required. An isocentric gantry mounted cyclotron serves a single treatment room with a direct beam line.
    Beam Transport MagnetsYes (IBA); No external steering magnets (MEVION S-250)No external steering magnets required
    Treatment ConfigurationCompact Single Room Treatment MachineCompact Single Room Treatment Machine
    Treatment TableRobotic Couch with 6 degrees of freedomRobotic Couch with 6 degrees of freedom
    Patient Positioning SystemRadiographic or CT assisted positioning systemRadiographic or CT assisted positioning system (Verity: 2D/3D with X-rays, 3D/3D with CT)
    Beam Delivery ModalityPencil Beam Scanning (IBA); Double Scatter (MEVION S-250)Pencil Beam Scanning
    Range in patient5 g/cm² - 32 g/cm²0.8 g/cm² - 32.2 g/cm²
    Dose Rate> 2Gy/Min> 2Gy/Min
    Spot Size≤ 15 mm on the range of energies (IBA); Not Applicable (MEVION S-250)≤ 5 mm at maximum energy (depth) to 15 mm at minimum energy (depth)
    Spot Position Accuracy≤ 15% of beam sigma or
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