REX, VERSION 3.0
Device Facts
| Record ID | K030457 |
|---|---|
| Device Name | REX, VERSION 3.0 |
| Applicant | Pointdx, Inc. |
| Product Code | LLZ · Radiology |
| Decision Date | Apr 8, 2003 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 892.2050 |
| Device Class | Class 2 |
| Attributes | Software as a Medical Device |
Indications for Use
REX™ 3.0 is a software package intended for viewing and manipulating DICOM-compliant medical images acquired from CT and MR scanners. REX™ 3.0 can be used for real-time image viewing, image manipulation, 3D volume rendering, virtual endoscopy, and issuance of reports.
Device Story
REX™ 3.0 is a software package for viewing and manipulating DICOM-compliant CT and MR images. It operates on off-the-shelf PCs. Input consists of DICOM-compliant medical images; output includes 3D volume rendering, virtual endoscopy views, and clinical reports. Used in clinical settings by trained physicians for image review, manipulation, and reporting. The software facilitates real-time viewing, 3D volume rendering, and virtual endoscopy to assist in lesion localization and clinical decision-making. Benefits include enhanced visualization of anatomical structures and streamlined reporting workflows.
Clinical Evidence
Bench testing only. Validation testing confirmed the software performs all input/output functions and required actions according to the Software Requirements Specification. Conformance to DICOM 3.0 verified.
Technological Characteristics
Software-only device; operates on off-the-shelf PC hardware; Windows 2000 OS; DICOM 3.0 compliant; supports PNG lossless image output; features include 3D volume rendering, virtual endoscopy, and multi-planar reformatting.
Indications for Use
Indicated for viewing and manipulating DICOM-compliant CT and MR medical images for trained physicians.
Regulatory Classification
Identification
A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.
Special Controls
*Classification.* Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).
Predicate Devices
Submission Summary (Full Text)
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K030457
## Section II - Section 510(k) Premarket Notification Summary (as required by 807.92 (j))
APR 0 8 2003
## Submitter:
PointDx, Inc. 635 West Fourth Street, Suite 200 Winston-Salem, NC 27101 Phone: 336.723.1450 Fax: 336.723.1458
#### Date Prepared:
February 7, 2003
## Contact Person(s):
Robert Anderson, Chief Operating Officer Francis Bonk, Director of Quality Assurance and Regulatory Affairs 336-723-1450 (v) 336-723-1458 (f)
Device Trade Name:
REXTM
## Device Common Name:
PACS / Image Processing Software
#### Classification Name:
Class II - System, Image Processing, RA (90) LLZ
#### Substantially Equivalent To:
| REX TM 1.0 | Rapidia® V 2.0 |
|-------------------------|---------------------------|
| (K021099) | (K012290) |
| PointDx, Inc. | 3D Med Co, Ltd. |
| 635 West Fourth Street | 940-319 Research Park |
| Suite 200 | SNU, San 4-8 |
| Winston-Salem, NC 27101 | Bongcheon-dong, Gwanak-gu |
| USA | Seoul 151-818 |
| | Republic of Korea |
#### Device Description:
REX™ 3.0 is a tool for 3D (three dimensional) and 2D (two dimensional) viewing and manipulation of DICOM compliant CT and MR images. The proposed software provides real-time image viewing, image manipulation, 3D volume rendering, virtual endoscopy, and issuance of reports.
#### Indications for Use:
REX™ 3.0 is a software package intended for viewing and manipulating DICOM-compliant medical images acquired from CT and MR scanners. REX™ 3.0 can be used for real-time image viewing, image manipulation, 3D volume rendering, virtual endoscopy, and issuance of reports.
#### Technological Comparison to Predicate Device:
The proposed and predicate devices are both software programs that can be used for manipulation of DICOM-compliant CT and MR images. The proposed and predicate software can be operated from a personal computer. REX™ 3.0 adds the capability to display MR images to REX™ 1.0 and
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convenience of using two monitors, one for image viewing, and the other for report viewing. The REX™ 3.0 software has substantially equivalent features and specifications versus the existing REX™ 1.0 and Rapidia® V 2.0, for those features and specifications the two devices have in common.
## Non-Clinical Performance Data:
The proposed REX™ 3.0 software conforms to DICOM (Digital Imaging and Communications in Medicine) Version 3.0. Validation testing confirms that REX™ 3.0 performs all input functions, output functions, and all required actions according to the functional requirements specified in the Software Requirements Specification.
To ensure performance to specifications, Federal Regulations and user requirements:
- Software Development Practices and .
- The Validation and Verification Process .
have been followed. Procedures specify individuals within the organization responsible for developing and approving product specifications, coding and testing, validation and maintenance.
## Adverse Effects on Health:
The potential hazards are identified in the Hazard Analysis and are controlled by:
- Designing controls directed at the cause and/or ●
- Introducing protective measures and/or ●
- Warning the Users. .
## Conclusions:
REX™ 3.0 does not result in any new potential safety risks and performs in accordance with its intended use as well as REX™ 1.0 and Rapidia® V 2.0 devices currently on the market. PointDx considers features of REX™ 3.0 to be substantially equivalent to REX™ 1.0 (K021099) with the addition of MR image analysis functions and a subset of features in common with the Rapidia® V 2.0 (K012290) device.
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# Substantial Equivalence Chart
| System | REX™ | REX™ | Rapidia® |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Version | 3.0 | 1.0 | 2.0 |
| Manufacturer | PointDx, Inc. | PointDx, Inc. | 3D Med Co., Ltd. |
| 510(k) Number | - | (K021099) | K012290 |
| Classification | Class II<br>892.2050<br>90 LLZ | Class II<br>892.2050<br>90 LLZ | Class II<br>892.2050<br>90 LLZ |
| Intended Use | REX™ 3.0 is a software<br>package intended for<br>viewing and manipulating<br>DICOM-compliant<br>medical images acquired<br>from CT and MR<br>scanners. REX™ 3.0 can<br>be used for real-time<br>image viewing, image<br>manipulation. 3D volume<br>rendering, virtual<br>endoscopy, and issuance<br>of reports. | REX™ 1.0 is a software<br>package intended for<br>viewing and manipulating<br>DICOM-compliant<br>medical images acquired<br>from CT scanners. REXTM<br>1.0 can be used for real-<br>time image viewing<br>image manipulation. 3D<br>volume rendering, virtual<br>endoscopy, and issuance<br>of reports. | Rapidia® is a software<br>package intended for<br>viewing and manipulating<br>DICOM-compliant<br>medical images from CT<br>and MR scanners.<br>Rapidia® can be used for<br>real-time viewing, image<br>manipulation.<br>segmentation, 3D volume<br>and surface rendering.<br>virtual endoscopy, and<br>issuing reports. |
| Graphical User Interface | Yes | Yes | Yes |
| Platform | PC | PC | PC |
| PC | Yes | Yes | Yes |
| Operating System | | | |
| Windows 2000 | Yes | Yes | Yes |
| Windows XP | No | No | Yes |
| Windows NT | No | No | Yes |
| Image Display Monitor | 1 | 1 | 1 |
| Report Display Monitor | 1 | 1 | Unspecified |
| Patient Demographics | Yes | Yes | Yes |
| Networking | | | |
| TCP/IP | Yes | Yes | Yes |
| Image Communication | | | |
| DICOM 3.0<br>compliant | Yes | Yes | Yes |
| Image Compression | | | |
| PNG (Lossless) | Yes | Yes | Unspecified |
| Image Processing | | | |
| Annotations - | Yes | Yes | Yes |
| System | REX™ | REX™ | Rapidia® |
| 3D Image Processing<br>Volume rendering | Yes | Yes | Yes |
| Image Review<br>Still | Yes | Yes | Yes |
| Window | Yes | Yes | Yes |
| Level | Yes | Yes | Yes |
| Zoom | Yes | Yes | Yes |
| Pan | Yes | Yes | Yes |
| Flip | Yes | Yes | Yes |
| 2D Measurements<br>Length | Yes | Yes | Yes |
| Area | Yes | Yes | Yes |
| Image Source<br>CT | Yes | Yes | Yes |
| MR | Yes | No | Yes |
| Image Input<br>DICOM 3.0 | Yes | Yes | Yes |
| Image Output | PNG (lossless snapshots) | PNG (lossless snapshots) | JPEG, BMP, DICOM |
| Use Standard Monitor | Yes | Yes | Yes |
| Patient and Study Browser | Yes | Yes | Yes |
| Multi Planer Reformatting | Yes | No | Yes |
| Measure Image Intensity Values<br>ROI | Yes | Yes | Yes |
| Type of Software<br>Standalone | Yes | Yes | Yes |
| Virtual Endoscopy<br>Instant access to lesions by single click | Yes | Yes | Yes |
| Real time display of endoscopic view | Yes | Yes | Yes |
| Internal and external viewing of any hollow structures | Yes | Yes | Yes |
| Fly-through | No | No | Yes |
| Real time interactive correlation among 3D image, endoscopic image and MPR images with respect to the point of view, viewing area and lesion localization | No | No | Yes |
| System | REX™ | REX™ | Rapidia® |
| Display multiple objects in different color and opacity | No | No | Yes |
| Local Image Storage | Yes | Yes | Yes |
| True Color | Yes | Yes | Yes |
| User Login | Yes | Yes | Unspecified |
| Preset Window and Level | Yes | Yes | Yes |
| Image Conversion | Yes (for viewing in browser) | Yes (for viewing in browser) | Yes |
| Device Users<br>Trained Physicians | Yes | Yes | Yes |
| Compliance Standards<br>DICOM 3.0 | Yes | Yes | Yes |
| Algorithms<br>Volume Rendering | Yes | Yes | Yes |
| Reporting | Yes | Yes | Yes |
| Physical Characteristics | Software Package Operates on off-the-shelf hardware (multiple vendors) Windows 2000 operating system DICOM compatible | Software Package Operates on off-the-shelf hardware (multiple vendors) Windows 2000 operating system DICOM compatible | Software Package Operates on off-the-shelf hardware (multiple vendors) Windows 2000, XP, or NT operating system DICOM compatible |
| Safety | Clinician interactive review/editing of data integral to use | Clinician interactive review/editing of data integral to use | Unspecified |
Tabular Comparison of Features and Specifications of REX™ 3.0, REX ™ 1.0 and Rapidia® V2.0
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Table 1. Substantial Equivalence
:
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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
# APR 0 8 2003
Mr. Francis Bonk Director of Quality Assurance and Regulatory Affairs PointDx. Inc. 635 West Fourth St., Suite 200 WINSTON-SALEM NC 27101 Re: K030457 Trade/Device Name: REX™ 3.0 PACS / Image Processing Software Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: 90 LLZ Dated: February 7, 2003 Received: February 11, 2003
Dear Mr. Bonk:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. Iisting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean r that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (sections 531-542 of the Act); 21 CFR 1000-1050.
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This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of the letter:
| 8xx.1xxx | (301) 594-4591 |
|----------------------------------|----------------|
| 876.2xxx, 3xxx, 4xxx, 5xxx | (301) 594-4616 |
| 884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx | (301) 594-4616 |
| 892.2xxx, 3xxx, 4xxx, 5xxx | (301) 594-4654 |
| Other | (301) 594-4692 |
Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97) you may obtain. Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.
Sincerely yours,
Nancy C. Brogdon
Nancy C. Brogdon Director, Division of Reproductive, Abdominal and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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510(k) Number (if known): K 8 3 045 7
Device Name: REX™ 3.0 PACS / Image Processing Software
## INDICATIONS FOR USE:
Intended Use:
Indications for Use:
REX™ 3.0 is a software package intended for viewing and manipulating DICOM-compliant medical images acquired from CT and MR scanners. REX™ 3.0 can be used for real-time image viewing, image manipulation, 3D volume rendering, virtual endoscopy, and issuance of reports.
#### (PLEASE DO NOT WRITE BELOW THIS LINE -- CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)
Prescription Use _ X Per 21 CFR 801.109
OR
Over-The-Counter Use)
David R. Ingram
(Division Sign-Off) Division of Reproductive, Abdomina and Radiological Devices 510(k) Number _
