TEM 3000 HEAD COIL

K040937 · Mr Instruments, Inc. · MOS · Apr 23, 2004 · Radiology

Device Facts

• Record ID: K040937
• Device Name: TEM 3000 HEAD COIL
• Applicant: Mr Instruments, Inc.
• Product Code: MOS · Radiology
• Decision Date: Apr 23, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.1000
• Device Class: Class 2
• Attributes: Pediatric, 3rd-Party Reviewed

Intended Use

The MR Instruments TEM 3000 Head Coil is intended for high-resolution whole-head adult and pediatric imaging. Typical applications include functional MRI, spectroscopy and angiography. It is compatible with the Siemens 3T Magnetom Trio MR System (K021330).

Device Story

TEM 3000 Head Coil is a 15-element quadrature transmit/receive RF coil for MRI systems; used for high-resolution imaging of brain, soft tissues, and vasculature. Device consists of coil elements and circuitry in a rigid housing with an open viewing window and a head support/coil base for patient positioning. Operates by receiving/transmitting RF signals within a Siemens 3T Magnetom Trio MR scanner. Employs Transverse Electromagnetic (TEM) technology using distributed components to generate RF fields, offering efficiency at high frequencies. Used in clinical settings by radiologists and MRI technicians. Output is raw MR signal data processed by the host scanner into diagnostic images; assists clinicians in diagnosing neurological conditions and vascular pathologies. Benefits patients through improved image quality and comfort during head scans.

Clinical Evidence

No clinical data. Bench testing only.

Technological Characteristics

15-element quadrature transmit/receive RF coil. Employs Transverse Electromagnetic (TEM) technology with distributed components. Rigid housing with open viewing window and head support base. Compatible with Siemens 3T Magnetom Trio MR systems. No software or algorithm components.

Indications for Use

Indicated for high-resolution whole-head imaging of the brain, soft tissues, and vasculature in adult and pediatric patients. Compatible with Siemens 3T Magnetom Trio MR systems.

Regulatory Classification

Identification

A magnetic resonance diagnostic device is intended for general diagnostic use to present images which reflect the spatial distribution and/or magnetic resonance spectra which reflect frequency and distribution of nuclei exhibiting nuclear magnetic resonance. Other physical parameters derived from the images and/or spectra may also be produced. The device includes hydrogen-1 (proton) imaging, sodium-23 imaging, hydrogen-1 spectroscopy, phosphorus-31 spectroscopy, and chemical shift imaging (preserving simultaneous frequency and spatial information).

Special Controls

*Classification.* Class II (special controls). A magnetic resonance imaging disposable kit intended for use with a magnetic resonance diagnostic device only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

Predicate Devices

• Magnetom Trio Head Coil (K021330)

Submission Summary (Full Text)

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K040937

APR 2 3 2004

Image /page/0/Picture/2 description: The image shows the logo for MR Instruments Inc. The logo consists of the letters "mrii" in a stylized font, with the "o" in "mrii" filled with a textured pattern. Below the letters, the words "MR INSTRUMENTS INC" are printed in a simple, sans-serif font.

### 510(k) SUMMARY of SAFETY and EFFECTIVENESS

# A. General Information

- MR Instruments, Inc. 1. Submitter's Name:
- 4802 Park Glen Road 2. Address: Minneapolis, MN 55416
- 3. Telephone: [phone]
- Gene Berghoff 4. Contact Person:
- 5. Date Prepared: April 7, 2004
- 6. Registration Number: Pending

#### B. Device

- TEM 3000 Head Coil 1. Name: TEM 3000 Head Coil 2. Trade Name: Common Name: Head Coil 3. Classification Name: Magnetic Resonance Diagnostic Device 4. 5. Product Code: 90MOS 6. Class: II 892.1000 7. Regulation Number:
SCO4
RA
II

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K040937

Image /page/1/Picture/1 description: The image shows the logo for MR Instruments INC. The logo consists of the letters 'mr' in a stylized font, with the 'm' and 'r' connected. Below the letters is the text 'MR INSTRUMENTS INC' in a smaller, sans-serif font. The logo is black and white.

## C. Identification of Legally Marketed Devices

| 1. Name: | Magnetom Trio Head Coil |
|------------------|-------------------------|
| 2. K Number: | K021330 |
| 3. Date Cleared: | July 25, 2002 |

#### D. Description of the Device

The TEM 3000 Head Coil is a 15-element quadrature transmit/receive coil. The coil elements and associated circuitry are enclosed in a rigid housing to prevent any exposure to patient or environment. The coil housing employs a large open viewing window on the top. The coil design facilitates the scanning of patients with different window on the top: "Ifizes patient comfort and ease of use. Included with the coil housing is a Head Support/Coil Base. It allows the coil to be slid back for better patient access.

#### E. Intended Use Statement

The MR Instruments TEM 3000 Head Coil is intended for 'H high-resolution whole-I head adult and pediatric imaging. Typical applications include functional MRI, spectroscopy and angiography. It is compatible with the Siemens 3T Magnetom Trio MR System (K021330).

## F. Technological Characteristics Summary

The TEM 3000 Head coil is similar to the predicate device, the USA Instruments 3T head coil manufactured for the Siemens Magnetom Trio system, in regard to its construction and operation. The key difference is the use of TEM (Transverse Electromagnetic) technology rather than the commonly used "Birdcage" technology. This means the coil develops the necessary RF field using "distributed" (transmission I mis momis the con as a responsible or discrete components. As a result, the TEM coil has the potential of being more efficient at higher frequencies.

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Image /page/2/Picture/2 description: The image shows the logo for the Department of Health & Human Services USA. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle or other bird with three curved lines representing its body and wings.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

APR 2 3 2004

MR Instruments, Inc. % Mr. Mark Job Responsible Third Party Regulatory Technology Services LLC 1394 25th Street NW BUFFALO MN 55313

Re: K040937

Trade/Device Name: TEM 3000 Head Coil Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: II Product Code: 90 MOS Dated: April 8, 2004

Received: April 12, 2004

Dear Mr. Job:

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, listing 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 such 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 I DA's issuance of a substantial equivalence determination does not mean 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) I his letter will anow you've of substantial equivalence of your device to a legally premarket notification: - The PDF intally sition 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 If you desire specific acvies to: your of the following numbers, based on the regulation number at the top of the letter:

| 8xx. 1xxx | [phone] |
|----------------------------------|----------------|
| 876.2xxx, 3xxx, 4xxx, 5xxx | [phone] |
| 884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx | [phone] |
| 892.2xxx, 3xxx, 4xxx, 5xxx | [phone] |
| Other | [phone] |

Additionally, for questions on the promotion and advertising of your device, please contact the Additionally, to: questions of [phone]. Also, please note the regulation entitled, "Misbranding Other of Othernation as ( notification" (21CFR Part 807.97) you may obtain. Other general of releveloo to premarited in the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Nancy C. brigden

Nancv 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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# Indication for Use Form

Koyo 937 510(k) Number:

Device Name: TEM 3000 Head Coil

Indications for Use: The TEM 3000 head coil is designed to provide Thurcations for 'Osci Images of the brain, soft tissues and Magnetic Resomation of the TEM 3000 head coil is vasculature of the nead. The TEAT 5000 head coanner manufactured by Siemens Medical Systems.

### PLEASE DO NOT WRITE BELOW THIS LINE -CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use _

OR
David A. Seyram

OVER-THE-COUNTER USE __ (optional Form 1-2-96)

/ 2007/2007

10

(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number KD40937