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510(k) Data Aggregation

    K Number
    K251317
    Date Cleared
    2025-09-05

    (129 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Product Code :

    HAW

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use
    Device Description
    AI/ML Overview
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    K Number
    K250893
    Date Cleared
    2025-09-04

    (163 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Product Code :

    HAW

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use
    Device Description
    AI/ML Overview
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    K Number
    K250505
    Device Name
    EZ-FIDUCIALS
    Manufacturer
    Date Cleared
    2025-07-09

    (138 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
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    Product Code :

    HAW

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

    Phasor EZ-Fiducials is intended to provide fixed reference point(s) in patients requiring stereotactic surgery in conjunction with CT imaging with the included screws placed using the included EZ-Driver (electric screwdriver) or manual screwdriver exclusively for each.

    Device Description

    Phasor EZ-FIDUCIALS™ provide fixed reference points during neurosurgical procedures. The device is composed of 3 items, all single-use, provided gamma-sterilized, and placed within the same primary packaging (sealed Tyvek tray within a shelf carton):

    1. Screws: Each of the four provided titanium screws is identical, with specific dimensions of each EZ-Fiducials screw as follows: screwhead circular shape screwhead with square-shaped engagement, non-threaded shaft diameter 2.9mm and length 15mm, threaded shaft diameter (major threads) 1.98mm, thread length 5mm; no protective caps are provided, and the screws should exclusively be utilized in conjunction with the screwdrivers (manual or EZ-Driver) provided together in the same tray (and with no other screwdriver);

    2. Manual Screwdriver: handheld, to be solely used with the screws provided, not intended for use with any other screws;

    3. EZ-driver: (electric, handheld, non-rechargeable battery-operated screwdriver, without software, single-use for solely tightening or loosening the provided screws exclusively, not intended for use with any other screws).

    AI/ML Overview

    The provided FDA 510(k) clearance letter and summary for EZ-Fiducials focuses primarily on substantial equivalence to predicate devices based on technological characteristics and bench testing, rather than a clinical study with acceptance criteria based on human-in-the-loop performance or algorithm-only performance against a defined ground truth.

    Therefore, for aspects related to "device performance," "acceptance criteria," "sample size," "expert ground truth," "adjudication methods," "MRMC studies," "standalone performance," and "ground truth for training/test sets," the available document does not provide this information. The submission relies on bench testing to demonstrate equivalence.

    Here's an analysis of what information is provided and what explicitly is not provided based on your request:


    Acceptance Criteria and Device Performance (Based on Available Information)

    The document does not present a table of acceptance criteria and reported device performance in the manner typically seen for clinical or AI/algorithm performance studies (e.g., sensitivity, specificity, accuracy). Instead, it relies on demonstrating compliance with an ASTM standard and general performance adequacy, often by comparison to predicate devices' known characteristics.

    Table of Acceptance Criteria and Reported Device Performance (as inferred from the document):

    Acceptance Criteria Category (Inferred)Specific Standard/RequirementReported Device Performance (EZ-Fiducials)Met?
    Material BiocompatibilityBiocompatible materialsYesYes
    SterilityGamma-sterilizedYes, single-use, gamma-sterilizedYes
    Single-useDisposableYesYes
    Fiducial Screw Purchase/DeflectionFirm purchase into bone simulant; compliant with ASTM F543-23Verified by testing for deflection using CMM; compliant with ASTM F543-23Yes
    Electric Screwdriver FunctionalityAbility to drive/remove screws; adequate performance (per report "02670-019011-1" including Table 6)Performs adequately, speed 30rpm (different from reference 120rpm, but supported by performance testing)Yes
    Packaging IntegrityMaintain sterilitySealed Tyvek tray within a shelf cartonYes
    Safety ConsiderationsSafe operationNo negative impact on safety compared to predicatesYes

    Study Proving Device Meets Acceptance Criteria

    The study proving the device meets acceptance criteria is primarily bench testing. No clinical study data is presented.

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

    • See table above. This is inferred from the discussion of performance testing. Explicit quantitative acceptance criteria (e.g., "deflection must be less than X mm") are not detailed, but compliance with ASTM F543-23 and "adequate performance" are stated.

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

    • Sample Size: Not explicitly stated for bench testing. The testing refers to "bone simulant" but the quantity of fiducials, screws, or instances tested is not specified.
    • Data Provenance: Not applicable in terms of patient data. The testing is bench testing using "bone simulant." There is no indication of retrospective or prospective data or country of origin, as it's not a clinical study.

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

    • Not applicable. This was a bench study, not a study requiring expert ground truth for clinical cases. The "ground truth" for the bench testing would be physical measurements and compliance with engineering standards.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

    • Not applicable. There was no human interpretation or subjective assessment of clinical data that would require adjudication.

    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:

    • No. An MRMC study was not done. The device is a physical fiducial system and an electric screwdriver, not an AI or software device that assists human readers.

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

    • Not applicable. This is not an AI algorithm. The device performance here refers to the physical characteristics and functionality of the fiducials and screwdriver.

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

    • Bench Testing Data/Engineering Standards. The ground truth for this submission's performance assessment is the physical performance and measurements of the device (deflection) and compliance with industry standards (ASTM F543-23).

    8. The sample size for the training set:

    • Not applicable. This device does not use machine learning or AI, so there is no training set.

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

    • Not applicable. As above, no training set.

    Summary of the Study:

    The "study" referenced in the 510(k) for EZ-Fiducials is a series of bench tests focusing on:

    • Biocompatibility of materials.
    • Sterility validation.
    • Packaging integrity.
    • Performance of the screws (e.g., deflection characteristics, compliance with ASTM F543-23 when inserted into bone simulant).
    • Performance of the electric screwdriver (its ability to drive screws adequately).

    The clearance is based on the argument that these bench tests demonstrate the device's substantial equivalence in terms of safety and effectiveness to the predicate device (Medtronic Navigus Unibody Fiducial Marker System) and a reference device (OsteoMed Pinnacle Driver), even with some technological differences (e.g., screwdriver speed, sterilization method). The document explicitly states: "No clinical testing was needed or performed otherwise." The predicate device was also "cleared based upon bench testing alone."

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    K Number
    K242575
    Date Cleared
    2025-05-23

    (267 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    Stereotaxic Guiding Surgical Devices, NaoTrac S is intended for the spatial positioning and orientation of instrument holder or instrument tool to be used by neurosurgeons to guide standard neurosurgical instruments (biopsy needle, stimulation or recording electrode). The device is indicated for any neurosurgical procedure in which the use of stereotactic surgery may be appropriate.

    Device Description

    Stereotaxic Guiding Surgical Devices, NaoTrac S is a robotized platform for the guidance of neurosurgical instruments compatible with the diameter of instrument adaptor provided by Brain Navi Biotechnology Co., Ltd.

    Stereotaxic Guiding Surgical Devices, NaoTrac S is composed of a compact robotic arm and display screen mounted on a wheeled trolley. Different types of instruments may be attached to the end of the arm and changed according to the requirements of the procedure to be completed.

    The display screen permits to ensure the communication between NaoTrac S and its user by indicating the realizable actions as well as by proposing various commands. NaoTrac S is an aid for locating anatomical structures in either open or percutaneous procedures.

    AI/ML Overview

    The provided FDA 510(k) Clearance Letter for the Stereotaxic Guiding Surgical Devices, NaoTrac S (K242575) includes details on acceptance criteria and supporting studies.

    Here's an analysis of the requested information based on the document:


    1. Table of Acceptance Criteria and Reported Device Performance

    Acceptance CriteriaReported Device Performance (NaoTrac S)
    Positional Error (Euclidean distance)
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    K Number
    K241327
    Manufacturer
    Date Cleared
    2025-02-05

    (271 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    Navient is a computerized surgical navigation system intended as an aid for precisely locating anatomical structures in either open or percutaneous neurosurgical procedures.

    The Navient system is indicated for any medical condition in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as the skull, can be identified relative to a CT, MR based model of the anatomy.

    Indications:

    Example procedures include but are not limited to:

    • Cranial Procedures:
    • Tumor resections
    • · Cranial biopsies
    • · Craniotomies
    • · Pediatric Catheter Shunt Placement
    • General Catheter Shunt Placement
    Device Description

    Navient is an image quided navigational system intended to assist with preoperative planning and real-time positioning of surgical tools during stereotaxic procedures via (infrared) tracking technology. The system is essentially composed of a computerized main unit (computer), a Navient IR CameraBox, Navient cart, Navient navigation software, and corresponding accessory sets intended for specific clinical applications.

    Navient's quidance function is based on the patient images acquired prior to the procedure, combined with optical measurements of the pose of navigated instruments relative to the patient's anatomy. To enable navigation, the reference instrument/accessory is attached to the patient to enable tracking of the patient's anatomy. The patient images are then spatially registered with the patient's anatomy by matching landmark locations marked on both the image and the patient, followed by matching a path traced by the user on the patient's anatomy with a model of patient's anatomical surface automatically generated from the image data.

    Depending on the desired clinical application, the Navient system also includes the following instrument/accessory kits. These reusable instruments are intended to be sterilized/disinfected prior to use.

    • Cranial Accessory Kit (955-NC-AKC) o
    • Biopsy Accessory Kit (955-NC-AKB) O

    Disposable tracker instruments are also available based on user preference.

    AI/ML Overview

    The provided document is a 510(k) summary for the ClaroNav Navient Image Guided Navigation System, Cranial. This document describes the device, its intended use, technological characteristics, and performance data to demonstrate substantial equivalence to a predicate device.

    Acceptance Criteria and Device Performance:

    The primary acceptance criteria for the Navient system is its accuracy, specifically in terms of positional and angular error. The document states: "Navient has been validated to a mean positional error of ≤ 2.0 mm and a mean anqular error of ≤ 2.0deq."

    Here's a table summarizing the acceptance criteria and reported device performance:

    Acceptance CriterionRequirementReported Device Performance (Mean)Standard Deviation99% Confidence Interval
    Positional Error (mm)≤ 2.0 mm (mean)1.36 mm0.66 mm2.89 mm
    Angular Error (degree)≤ 2.0 deg (mean)1.01 deg0.40 deg1.95 deg
    Accuracy when exchanging cranial reference frame
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    Product Code :

    HAW

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

    Alignment System Cranial is intended to plan and to achieve a trajectory with surgical instruments during cranial stereotactic procedures.

    The indications for use are biopsy of intracranial lesions, placement of stereoelectroencephalography (SEEG) electrodes and placement of anchor bolts for laser interstitial thermal therapy (LITT).

    Device Description

    The subject device Alignment System Cranial is an image guided surgery system intended to support the surgeon to plan and to achieve a trajectory with surgical instruments during cranial stereotactic procedures using optical tracking technology.

    For this purpose, the Alignment System Cranial consists of a combination of hardware and software. The Alignment Software Cranial with LITT 2.1 is installed on an Image Guided Surgery (IGS) platform (Curve, Curve Navigation 17700, Kick 2 Navigation Station or Buzz Navigation) consisting of a computer unit, a touch display and an infrared tracking camera. During surgery, the software tracks the position of instruments in relation to the patient anatomy and identifies this position on pre- or intraoperative images. The position of the surgical instruments is continuously updated on these images by optical tracking. This position information is used by the software to align either passive or active positioning devices to a planned trajectory for subsequent surgical steps.

    The Alignment System Cranial has different configurations of hardware devices depending on which positioning device is used and which indication is performed. The Alignment Software Cranial with LITT 2.1 supports the active positioning devices Surgical Base System 1.4 and Cirq Arm System 2.0 (+ Cirq Robotic Alignment Module + Cirq Robotic Disposable Kinematic Unit) as well as the passive positioning device VarioGuide. Both types of positioning devices consist of articulated arms with different joints where additional devices and surgical instruments can be attached to for further manual or robotic alignment to a defined trajectory.

    In addition, the subject device offers a set of indication specific instruments to support biopsy, sEEG and LITT procedures. This instrumentation consists of instrument holders, tracking arrays, guide tubes, reduction tube, bone anchors, drill bits and depth stops. None of the instruments is delivered sterile. All patient contacting materials consist of different alloys of stainless steel.

    The Alignment Software Cranial with LITT has the following accessories:

    • Automatic Registration providing an automatic registration for subsequent use.
    • Automatic Registration iMRI providing an automatic image registration for intraoperatively . acquired MR images.
    AI/ML Overview

    The provided text is a 510(k) summary for the "Alignment System Cranial," which includes "Alignment Software Cranial with LITT." It details the device's indications for use, description, and comparison to predicate devices, along with performance data to demonstrate substantial equivalence.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:

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

    Acceptance CriteriaReported Device PerformanceMeets Criteria?
    Mean Positional Error (instrument tip) ≤ 2 mmMean Positional Error: 1.19 mmYes
    Mean Angular Error (instrument axis) ≤ 2°Mean Angular Error: 0.86°Yes

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

    • Sample Size for Test Set:
      • Number of registrations: 6
      • Total number of samples: 37 (This likely refers to individual measurements taken over the 6 registrations)
    • Data Provenance: The document does not explicitly state the country of origin or whether the data was retrospective or prospective. However, the study was conducted as "System accuracy testing" to evaluate the device in "a realistic clinical setup and representative worst case scenarios," suggesting it was a controlled, prospective study performed by the manufacturer.

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

    The document does not provide information on the number of experts or their qualifications used to establish ground truth for this system accuracy testing. This type of testing typically relies on metrology standards and physical measurements rather than clinical expert consensus for ground truth.

    4. Adjudication method for the test set

    The document does not specify an adjudication method. For system accuracy testing based on physical measurements, an adjudication process involving human experts is generally not applicable in the same way it would be for image-reading or diagnostic AI.

    5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, and its effect size

    No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. The performance data presented is for the system accuracy of the device concerning its ability to align instruments, not for a diagnostic AI algorithm that human readers would interact with. The document explicitly states: "No clinical testing was needed for the Subject Device since optical tracking technology in the scope of image guided surgery for the included indications for use is well established in the market."

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

    The performance study was for the system's accuracy (hardware + software components), which is a key aspect of its standalone functionality in terms of guiding instruments. While it's not an "algorithm only" study in the sense of a pure AI diagnostic tool, it measures the precision of the device's output without direct human interpretation in the loop of the measurement itself. The "Automatic Registration" features (including one for iMRI) are mentioned as accessories, implying an algorithmic component, but specific performance criteria for these AI/ML-based features are not detailed beyond the general system accuracy. The document mentions that "There have been no changes to the AI/ML algorithm" for surface matching for patient registration, implying its prior validation.

    7. The type of ground truth used

    The ground truth for the system accuracy testing ("positional and angular navigation accuracy") would have been established through precise physical measurements using calibrated instruments and metrological standards (e.g., a coordinate measuring machine or similar setup to establish a true target position against which the device's reported position is compared). It is not based on expert consensus, pathology, or outcomes data, as this is a measurement of mechanical and software precision.

    8. The sample size for the training set

    The document does not provide information on the sample size for the training set for any embedded AI/ML components (e.g., the AI/ML based model for landmark delivery in surface matching). The focus of this 510(k) summary is on the system accuracy for the LITT indication, and asserts "no changes to the AI/ML algorithm" for patient registration.

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

    The document does not provide information on how the ground truth for any training set was established for embedded AI/ML components. It only mentions that an existing AI/ML algorithm for surface matching landmarks has not changed.

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    K Number
    K243657
    Date Cleared
    2025-01-24

    (58 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    The ClearPoint System is intended to provide stereotactic guidance for the placement and operation of instruments or devices during planning and operation of neurological procedures within an operating room environment and in conjunction with MR and/or CT imaging. During planning, the system is intended to provide functionality for the automatic identification, labeling, visualization of segmentable brain structures from a set of loaded MR images. The ClearPoint System is intended as an integral part of procedures that have traditionally used stereotactic methodology. These procedures include biopsies, catheter and electrode insertion including deep brain stimulation (DBS) (asleep or awake) lead placement. When used in an MRI environment, the system is intended for use only with 1.5 and 3.0 Tesla MRI scanners and MR Conditional implants and devices.

    Device Description

    The updated ClearPoint Software Version 3.0 introduces modifications to support a new clinical workflow using intraoperative CT imaging when compared to the previous ClearPoint Software Version 2.2 (K233243). The ClearPoint System described in this submission is essentially identical from a technological standpoint to the cleared predicate device described in K233243 (ClearPoint System version 2.2). As mentioned above, since the prior clearance, the company has implemented software features to enable usage of the ClearPoint System during CT-guided procedures, in addition to MR-guided procedures supported in the predicate device. The hardware components are unchanged from the device described in K233243 and minor changes were made to the indications for use.

    The ClearPoint System is comprised of a workstation laptop with software, the SMARTGrid Planning Grid, the SMARTFrame Trajectory Frame, the SMARTFrame Accessory Kit and the SMARTFrame Thumbwheel Extension. The SMARTGrid and associated Marking Tool are designed to assist the physician to precisely position the entry hole as called out in the trajectory planning software. The SMARTFrame is an Adjustable Trajectory Frame (ATF) that provides the guidance and fixation for neurosurgical tools. The image-visible fluids of the Targeting Cannula along with the fiducial markers in the base of the frame allows for trajectory feedback when the physician views the intraoperatively acquired images, makes changes and confirms with subsequent image acquisitions. Optionally, the ClearPoint System can be used with any head fixation frame to immobilize the patient's head with respect to the scanner table. ClearPoint Neuro also supplies an optional head fixation frame that can be used with the ClearPoint System. The ClearPoint Workstation includes the ClearPoint Workstation Software (for trajectory planning and monitoring) and a Laptop Computer. The hardware components of the current ClearPoint System are the SMARTFrame and Accessories. They are all single use devices that are provided sterile and include the SMARTGrid Planning Grid (Marking Grid, Marking Tool), SMARTFrame Pack (SMARTFrame or SMARTFrame XG, Centering Device and Wharen Centering Guide, Dock, Device Lock, Screwdriver, Roll Lock Screw and Washer), Rescue Screws (Extra Titanium Screws), Thumbwheel Extension, Accessory Kit (Peel-away Sheath, Stylet, Lancet, Depth Stop, Ruler), Scalp Mount Base, and Guide Tubes and Device Guide Packs (Guide Cannulas). In addition, the ClearPoint System is used with the separately cleared or Class I, 510(k) exempt products: SmartTip MRI Hand Drill and Drill Bit Kit, MRI Neuro Procedure Drape, with Marker Pen and Cover, and SmartFrame Fiducial.

    AI/ML Overview

    The provided document (K243657) is a 510(k) Premarket Notification for the ClearPoint System (Software Version 3.0), which is a stereotaxic instrument. The document primarily focuses on demonstrating substantial equivalence to predicate devices and detailing the non-clinical testing performed.

    Based on the provided text, here's a description of the acceptance criteria and the study that proves the device meets the acceptance criteria, addressing each point as much as possible:

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

    The document provides accuracy specifications in tables:

    Table 1: ClearPoint System Accuracy Specifications - MRI Guidance (Unchanged from predicate)

    Performance ValidationPositional Error (mm)Angular Error (deg.)
    ClearPoint SystemMean (X,Y,Z)Std. Dev.99% CIMeanStd. Dev.99% CI
    0.140.370.440.32°0.17°0.46°
    0.160.540.60
    0.560.570.10

    Note: The table layout in the original document for MRI accuracy is a bit unusual with duplicated rows for positional error, and it's not explicitly labelled as "acceptance criteria." However, it presents the validated performance.

    Table 2: ClearPoint System Accuracy Specifications - CT Guidance (New for v3.0)

    Precision ME (mm)Accuracy RMS (mm)Accuracy Max (mm)
    X0.10.170.3
    Y0.10.170.3
    Z0.10.170.3
    Roll0.1°0.17°0.3°
    Pitch0.1°0.17°0.3°
    Yaw0.1°0.17°0.3°
    Positional Error (mm)Trajectory Angle Error (Degrees)
    MeanStandard Deviation99% CI Upper BoundMeanStandard Deviation99% CI Upper Bound
    0.810.490.930.310.230.37

    Explicit Acceptance Criteria (from "Targeting Accuracy" row in Table 3 comparison):

    • Targeting Accuracy: ± 1.5 mm @ ≤125mm (This appears to be the primary specified acceptance criterion for overall targeting accuracy, presumably applying across both MRI and CT guidance given its placement in the general comparison table).

    Reported Device Performance:

    • MRI Guidance: Positional Error (99% CI) 0.44 mm, 0.60 mm, 0.10 mm. Angular Error (99% CI) 0.46°. These values are well within the ± 1.5 mm overall targeting accuracy.
    • CT Guidance: Positional Error (99% CI Upper Bound) 0.93 mm. Trajectory Angle Error (99% CI Upper Bound) 0.37°. These values are also well within the ± 1.5 mm overall targeting accuracy.

    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:

    • "Accuracy testing was performed using an MRI scanner to confirm that modifications included in the ClearPoint System 3.0 did not cause any unexpected changes in the accuracy specifications of the software, with successful results."
    • "Additionally, accuracy testing was performed in a CT scanner to validate the CT-guided clinical workflow that is new to the ClearPoint 3.0 software and establish new ground-truth accuracy specifications."

    However, the document does not specify the sample size for either the MRI or CT accuracy test sets.
    The data provenance is also not specified regarding country of origin or whether it was retrospective or prospective. Given the nature of accuracy testing for a stereotaxic device, these are typically phantom-based, prospective tests conducted in a controlled lab or clinical environment, rather than patient data studies.

    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)

    The document does not mention human experts for establishing ground truth for the accuracy tests. The accuracy testing described appears to be technical validation against a known physical ground truth (e.g., phantom measurements), as is common for stereotaxic instrument validation. Therefore, expert consensus on images is not relevant for this type of accuracy assessment.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    Not applicable, as the accuracy testing described is a technical validation against a physical ground truth, not a study evaluating human interpretation or a scenario requiring adjudication.

    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

    The document does not mention any MRMC comparative effectiveness study or any evaluation of human readers (even though the device has "automatic identification, labeling, visualization" of structures). The testing detailed is primarily focused on the system's technical accuracy in guidance, not on AI assistance for human image interpretation.

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

    Yes, the accuracy testing described in Section 6, "Non-Clinical Testing," and detailed in Tables 1 and 2, represents standalone (algorithm only) performance testing against a technical ground truth. It evaluates the system's precision and accuracy in positional and angular measurements.

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

    The ground truth used for the accuracy tests appears to be physical measurements from a phantom or test setup, given the context of "Positional Error" and "Angular Error" in millimeters and degrees. The document refers to "establish new ground-truth accuracy specifications" in relation to the CT testing, implying a precise, measurable standard. This is typical for the technical validation of stereotaxic guidance systems.

    8. The sample size for the training set

    The document does not specify a sample size for a "training set." The ClearPoint System 3.0 software introduces features like "automatic identification, labeling, visualization, and quantification of segmentable brain structures" and "Algorithms to automatically locate and identify marking grid, targeting frame components, cannula, and device tip from both MR and CT image sets." While these imply the use of machine learning or advanced algorithms that would require training data, the submission focuses on the validation of these features' accuracy, not on the details of their development (including training data specifics).

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

    Since the document does not discuss a training set, there is no information provided on how its ground truth was established. For the algorithms processing anatomical structures or hardware components, the ground truth for training data would typically involve manually annotated medical images by qualified personnel (e.g., radiologists, neurosurgeons, or trained annotators under expert supervision).

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    K Number
    K241333
    Date Cleared
    2025-01-17

    (252 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    The device is intended to aid in locating anatomical structures and for the spatial positioning and orientation of instrument holders or tool guides to be used by neurosurgeons for navigating compatible surgical instruments in open or percutaneous procedures. The device is indicated for any neurosurgical procedure in which stereotactic neurosurgery may be appropriate and where reference to a rigid anatomical structure, such as the skull, can be identified relative to anatomy images.

    Device Description

    Geniant Cranial is a hardware platform that supports real-time surgical navigation using medical patient images. The application software reprocesses the CT or MR images of the patient acquired before surgery. It displays the contents on the software screen in various fluoroscopy directions (axial, sagittal and coronal). Before surgery, the surgeon can create and save one or more surgical routes to simulate. The surgeon may create and manipulate one or more 3D models of human anatomy before the surgery. During surgery, the system tracks the position of special surgical tools in the patient's anatomy and continuously updates the positions of the surgical tools in these images. The application software can also show you how the actual position and path during surgery relate to the pre-operative plan and guide the surgeon to follow the planned trajectory. The real-time location information obtained through Genial can help guide the surgeon's decision and the surgical route.

    AI/ML Overview

    This document describes the acceptance criteria and the study proving the device meets them for the "Geniant Cranial (Navigated Neurosurgical Positioning Robot)".

    1. Table of Acceptance Criteria and Reported Device Performance

    Performance MetricAcceptance Criteria (from Predicate Device #2)Reported Device Performance (Geniant Cranial)
    3D Positional Accuracy (mean error)≤ 2.0 mm≤ 1.5 mm
    Trajectory Angle Accuracy (mean error)≤ 2.0 degrees≤ 2.0 degrees

    Detailed Performance Results for Geniant Cranial:

    Applied registration methodPositional Accuracy (mm) (Mean)Positional Accuracy (mm) (99% CI Upper Bound)Trajectory Angle Accuracy (degrees) (Mean)Trajectory Angle Accuracy (degrees) (99% CI Upper Bound)
    Paired Point Registration (PPR)0.7661.6160.2640.678
    Bone Fiducial Registration0.9161.9070.2920.750
    Tracing Registration0.8721.8490.3340.860

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

    The document does not specify the exact sample size for the test set used in the accuracy testing. It states that "Koh Young Technology considered all parameters that may influence the stereotactic procedure, which include the different devices, accessories, and components of Geniant Cranial, other influencing devices used in the procedure that are validated to be compatible with Genial, and other elements of the surgical environment" and that the testing was performed "Under the representative worst-case configuration considering an actual clinical procedure".

    The data provenance is not explicitly stated as retrospective or prospective, nor does it specify the country of origin. However, given that these are non-clinical performance and accuracy tests, the data likely originates from internal lab testing conducted by the manufacturer, Koh Young Technology Inc. (Republic of Korea).

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

    The document does not provide information on the number of experts used or their qualifications for establishing the ground truth for the non-clinical accuracy test set. As this is a non-clinical, performance-based test measuring instrument accuracy, the ground truth would likely be established through precise metrological measurements rather than human expert interpretation of medical images.

    4. Adjudication Method for the Test Set

    The document does not mention an adjudication method as it pertains to clinical interpretation or consensus. The described testing is a technical accuracy assessment, and thus, typical clinical adjudication methods (like 2+1, 3+1) are not applicable.

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

    No. The provided document does not mention any multi-reader multi-case (MRMC) comparative effectiveness study evaluating human reader improvement with or without AI assistance. The device is a "Navigated Neurosurgical Positioning Robot," which falls under the category of surgical navigation systems and is not an AI-assisted diagnostic imaging interpretation tool.

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

    Yes, a standalone performance study was conducted. The accuracy testing detailed in "Table 3 – Accuracy Testing Result" presents the inherent accuracy of the Geniant Cranial device itself (robot and navigation system) in simulating spatial positioning and trajectory guidance. This testing measures the device's ability to achieve specific positional and angular accuracy independent of a human operator's varying performance, by comparing its output against a known, precise "ground truth" established during the test setup.

    7. Type of Ground Truth Used

    The ground truth used for the accuracy studies was established through precise physical measurements to determine the true 3D positional and trajectory angle targets. These are technical benchmarks for device performance, not clinical pathology or outcomes data. The study references "ASTM F2554-18 Standard Practice for Measurement of Positional Accuracy of Computer Assisted Surgical Systems" and "ISO 9283:1998 Manipulating industrial robots - Performance criteria and related test methods," indicating that the ground truth was based on metrological standards for robotic and computer-assisted system accuracy.

    8. Sample Size for the Training Set

    The document does not specify a sample size for a training set. As this device is a surgical navigation robot and not a machine learning/AI diagnostic tool that requires image-based training, the concept of a "training set" in the context of data-driven algorithm development for image interpretation is not directly applicable here. The device's functionality is based on real-time tracking, image reprocessing, and robotic guidance, relying on established geometric and kinematic principles rather than statistical learning from a large training dataset.

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

    As explained in point 8, the document does not indicate the use of a "training set" in the context of machine learning. The device's operational principles rely on precise engineering and calibration rather than data-driven training. Therefore, the establishment of ground truth for a training set is not discussed or relevant to the reported performance evaluation.

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    K Number
    K242480
    Manufacturer
    Date Cleared
    2024-12-27

    (128 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    FLASH EVD is a stereotactic image guidance system intended for the spatial positioning and orientation of neurosurgical instruments. The device is only indicated for cranial surgery where reference to a rigid anatomical structure can be identified, does not require rigid fixation of the patient, and does not require fixation of a navigated instrument guide to the patient.

    Device Description

    FLASH EVD System is a stereotactic image guided surgical navigation system during cranial procedures. The FLASH EVD software assists in guiding surgeons during external ventricular drainage (EVD) catheter placement procedure, also known as a ventriculostomy, is prescribed to relieve elevated intracranial pressure when there is a disruption in the normal flow of cerebrospinal fluid (CSF) within the brain.

    AI/ML Overview

    The provided text describes the 7D Surgical FLASH EVD System and its 510(k) submission for clearance. However, it does not contain the detailed information necessary to fully answer all aspects of your request, particularly regarding specific acceptance criteria metrics and a multi-reader, multi-case (MRMC) comparative effectiveness study.

    The document primarily focuses on demonstrating substantial equivalence to a predicate device (7D Surgical System Cranial Biopsy and Ventricular Catheter Placement Application, K192945) through non-clinical testing.

    Here's a breakdown of what can be extracted and what information is missing based on your prompts:


    1. Table of Acceptance Criteria and Reported Device Performance

    The document specifies "System Accuracy Requirement" for the predicate device, which the FLASH EVD System also adopts as "Same as K192945." These are the closest things to acceptance criteria mentioned.

    Acceptance CriteriaReported Device Performance
    Linear Placement Error:
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    K Number
    K242351
    Manufacturer
    Date Cleared
    2024-10-04

    (57 days)

    Product Code
    Regulation Number
    882.4560
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    HAW

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

    The Zeta Cranial Navigation System is a stereotaxic image guidance system intended for the spatial positioning and orientation of neurosurgical instruments used by surgeons. The device is indicated only for cranial surgery where reference to a rigid anatomical structure can be identified, does not require rigid fixation of the patient, and does not require fixation of a navigated instrument guide to the patient. The system is intended to be used in operating rooms and in less acute surgical settings such as interventional procedure suites.

    Device Description

    The Zeta Cranial Navigation System is a stereotaxic, image guided planning and intraoperative guidance system enabling computer-assisted cranial interventional procedures. The system assists surgeons with the precise positioning of surgical instruments relative to patient anatomy by displaying the position of navigated surgical instruments relative to 3D preoperative medical scans.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the Zeta Cranial Navigation System, based on the provided document:

    1. Table of Acceptance Criteria and Reported Device Performance

    The document focuses on demonstrating substantial equivalence to a predicate device (Zeta Cranial Navigation System, K233903) rather than explicitly stating quantitative performance acceptance criteria in an easily digestible table. However, it implicitly uses various testing results to show the device meets safety and effectiveness requirements.

    Below is an attempted table based on the provided information, where "Acceptance Criteria" are implied by successful test completion and "Reported Device Performance" is the outcome of those tests.

    Acceptance Criteria (Implied)Reported Device Performance
    Adherence to Biocompatibility StandardsPatient contact information is not needed as there are no direct or indirect patient-contacting components of the device.
    Adherence to Electrical Safety Standards (IEC 60601-1)The device passed all tests.
    Adherence to Software Lifecycle Standards (IEC 62304)The device passed all tests.
    Adherence to Electromagnetic Compatibility (EMC) Standards (IEC 60601-1-2)The device passed all tests.
    Adherence to Usability Standards (IEC 60601-1-6)The device passed all tests.
    Software Verification and ValidationTesting was conducted, and documentation provided as recommended by FDA guidance. The software was considered a Major level of concern.
    Cybersecurity ManagementDocumentation was provided as recommended by FDA guidance.
    Cleaning and Sterilization EfficacyThe device is reusable, provided non-sterile, and is not sterile when used. Cleaning instructions are provided in the labeling.
    Shelf Life (Stability)Shelf-life is not applicable due to the low likelihood of time-dependent product degradation.
    Accuracy under various conditions (simulated clinical procedures, surgical illumination, dynamic patient motion, worst-case physical/environmental conditions)Tested and demonstrated substantial equivalence (implied satisfactory accuracy).
    Design ValidationPerformed to demonstrate substantial equivalence.
    Human Factors and UsabilityTesting was performed following FDA guidance.
    Navigation Frames Per SecondUncapped (mean 21fps) - Note: This is a performance metric, not an explicit acceptance criterion, but it implies meeting a functional requirement.

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

    The document does not specify a separate "test set" in the context of image data or patient studies for the subject device. The performance data provided is primarily from bench testing, electrical safety, software validation, and human factors testing.

    Specifically, for accuracy testing, it mentions:

    • "Simulated clinical procedures using virtual targets"
    • "Surgical illumination levels"
    • "Dynamic patient motion"
    • "Other worst-case physical and environmental conditions"

    However, the document does not provide details on:

    • The sample size of virtual targets, simulated procedures, or specific cases used for accuracy testing.
    • The provenance of any data (e.g., country of origin, retrospective/prospective) for these bench tests.

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

    This information is not provided in the document. The document describes bench testing and simulated environments rather than expert-adjudicated clinical data sets.

    4. Adjudication method for the test set

    This information is not provided as the testing described does not involve expert adjudication of a test set. The accuracy testing was likely measured against pre-defined virtual targets or established physical ground truths in a bench setting.

    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

    There is no mention of a multi-reader multi-case (MRMC) comparative effectiveness study being done, nor any data regarding human reader improvement with AI assistance. The Zeta Cranial Navigation System is described as an image guidance system for surgeons, not an AI-assisted diagnostic or interpretative tool for human readers of medical images.

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

    The document does not explicitly state "standalone performance" in the context of an algorithm. However, the accuracy testing and other bench tests (e.g., electrical safety, software validation) would inherently assess the device's functional performance independent of human interaction beyond operating the device. The "Navigation Frames Per Second" (mean 21fps) is a standalone performance metric for the system's real-time tracking capability.

    7. The type of ground truth used

    For the accuracy testing, the ground truth appears to be:

    • Virtual targets: For simulated clinical procedures.
    • Established physical ground truths: For accuracy measurements under various physical and environmental conditions.

    The document does not mention pathology, outcomes data, or expert consensus as ground truth for the performance evaluations described.

    8. The sample size for the training set

    The document does not provide any information regarding a training set or its sample size. This is consistent with the device being primarily a navigation system, where the software's role is real-time tracking and display based on established principles, rather than a machine learning model that requires extensive training data for image interpretation or diagnosis.

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

    As no training set is mentioned, this information is not provided.

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