FLEX AND LOOP COIL SET 1.5 T

K070629 · Siemens Medical Solutions · MOS · Mar 26, 2007 · Radiology

Device Facts

• Record ID: K070629
• Device Name: FLEX AND LOOP COIL SET 1.5 T
• Applicant: Siemens Medical Solutions
• Product Code: MOS · Radiology
• Decision Date: Mar 26, 2007
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.1000
• Device Class: Class 2
• Attributes: 3rd-Party Reviewed

Intended Use

The intended use of the Flex and Loop Coil Set 1.5 T is, in conjunction with a Magnetic Resonance Scanner, the MR examination of the human body. Used in the MAGNETOM Avanto, Espree and Symphony a Tim System, the Flex and Loop Coils are indicated for use as a diagnostic imaging device to produce transversal, sagittal, coronal and oblique images of the internal structures of the body. The images produced by the MAGNETOM Avanto, Espree and Symphony a Tim System with the Flex and Loop Coils reflect the spatial distribution of protons (hydrogen nuclei) exhibiting magnetic resonance. When interpreted by a trained physician, these images provide information that can be useful in determining a diagnosis. The intended use of the MAGNETOM Avanto, Espree and Symphony a Tim System is not affected in any way by the use of the new Flex and Loop Coil Set 1.5 T.

Device Story

Flex and Loop Coil Set 1.5 T is a receive-only accessory for MRI scanners (MAGNETOM Avanto, Espree, Symphony a Tim). Input: magnetic resonance signals from human body tissues. Operation: coils capture proton resonance signals; interface unit (preamplifiers, cable traps, combiner network) processes signals for scanner reconstruction. Output: transversal, sagittal, coronal, oblique images of internal body structures. Used in clinical radiology settings by trained medical professionals. Images interpreted by physicians to assist in diagnosis. Benefits: enables high-quality diagnostic imaging of internal anatomy.

Clinical Evidence

Bench testing only. Performance evaluated via Signal to Noise Ratio (SNR) and image uniformity testing according to NEMA MS-6 standards. Results demonstrate equivalence to predicate devices.

Technological Characteristics

Receive-only MRI coils; includes two 4-channel flexible coils and three linear polarized (LP) flexible coils (4 cm, 7 cm, 11 cm). Interface includes preamplifiers, cable traps, and combiner network. Designed for 1.5 T field strength. No new materials compared to predicate.

Indications for Use

Indicated for use as a diagnostic imaging device for MR examination of the human body to produce transversal, sagittal, coronal, and oblique images of internal structures. For use with MAGNETOM Avanto, Espree, and Symphony a Tim Systems. No specific age or gender restrictions stated.

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

• Flex Loop Coil Set 3 T (K063373)

Submission Summary (Full Text)

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K070629

Section 8 510(k) Summary

# 8 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR § 807.92.

### I. General Information MAR 2 6 2007 Date of summary preparation: February 13, 2007 Manufacturer Siemens AG, Medical Solutions Henkestrasse 127 D-91052 Erlangen, Germany Headquarters: Siemens AG Wittelsbacherplatz 2 D-80333 Munich, Germany Registration Number 8010024 Importer/Distributor Siemens Medical Solutions USA, Inc. 51 Valley Stream Parkway Malvern, PA 19355 Registration Number 2240869 Contact Person Mr. Helmut Neumann Regulatory Affairs Manager Henkestrasse 127 D-91052 Erlangen, Germany

Siemens 510(k) Premarket Notification February 13, 2007

e-mail: [e-mail]

Phone: [phone] Fax: [phone]

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#### Classification and Device Name

| Classification Panel: | Radiology |
|-----------------------|--------------------------------------|
| Classification Name: | Magnetic Resonance Diagnostic Device |
| | Accessory |
| Device Class: | Class II [21 CFR § 892.1000] |
| Product Code: | MOS |
| Common Name: | Special Purpose Coil |
| Trade Name: | Flex and Loop Coil Set 1.5 T |

#### Safety and Effectiveness Information Supporting Substantial II. Equivalence

#### Intended Use

The intended use of the Flex and Loop Coil Set 1.5 T is, in conjunction with a Magnetic Resonance Scanner, the MR examination of the human body. Used in the MAGNETOM Avanto, Espree and Symphony a Tim System, the Flex and Loop Coils are intended to produce transversal, sagittal, coronal and oblique images of the internal structures of the body.

#### Device Description

The Flex and Loop Coil Set 1.5 T consists of five receive-only coils and one interface, which contains the preamplifiers, cable traps and a combiner network. The coils are two 4-channel flexible coils (Flex Coil Large and Flex Coil Small) and three linear polarized (LP) flexible coils (Loop Coil 4 cm, 7 cm and 11 cm).

Image /page/1/Figure/8 description: The image shows two lines labeled (1) and (2). According to the text, (1) is the coil socket and (2) is the plug for the coil socket on the patient table. The lines point to the respective parts in the image.

Figure 8.II.1: Flex loop interface

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Image /page/2/Figure/1 description: The image shows three diagrams of a coil loop and coil plug. Each diagram has two labeled parts: (1) Coil loop and (2) Coil plug. The diagrams are simple line drawings, and the labels are placed near the corresponding parts of the coil.

Figure 8.II.2: Loop coils 4 cm, 7 cm, and 11 cm

Image /page/2/Figure/3 description: The image shows two diagrams of an electronic component, possibly a circuit board or a similar device. Each diagram has labels indicating different parts: (1) Center markings, (2) Electronic boxes, and (3) Coil plug. The diagrams appear to be technical illustrations, providing a visual representation of the component's structure and key features.

Figure 8.II.3: Flex Coil large and small

77

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### Equivalency Information

Siemens believes that the Flex and Loop Coil Set 1.5 T for MAGNETOM Avanto, Espree and Symphony a Tim System is substantially equivalent to the Flex Loop Coil Set for MAGNETOM 3 T systems described in the following submission:

| Device Name | FDA Clearance Number | FDA Clearance Date |
|---------------------------|----------------------|--------------------|
| Flex Loop Coil Set<br>3 T | K063373 | Nov 17, 2006 |

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Summary of Technological Characteristics of the Principal Device as Compared with the Predicate Device

Although the new Flex and Loop Coils are designed for a field strength of 1.5 T, Siemens believes that they are substantially equivalent to the predicate Flex Loop Coils for the 3 T MAGNETOM Trio a Tim System.

#### General Safety and Effectiveness Concerns

The following safety and performance parameters:

[Safety]

- Maximum Static Field
- Rate of Change of Magnetic Field
- RF Power Deposition
- Acoustic Noise Level

[Performance]

- Geometric Distortion
- Slice Profile, Thickness and Gap
- High Contrast Spatial Resolution

specified by the FDA Guidance document for MR Diagnostic Devices are unaffected by the modifications described within this notification.

The following parameters were considered for the new Flex and Loop Coil Set 1.5 T

[Safety] - Biocompatibility

[Performance] - Signal to Noise Ratio - Image Uniformity

No new materials were used for the new Flex and Loop Coil Set 1.5 T compared to their predicate device. Therefore no biocompatibility tests were performed. Signal to Noise Ratio (SNR) and image uniformity tests acc. to NEMA MS-6 standard were performed for the new Flex and Loop Coil Set 1.5 T and the results presented in this submission show that they are equivalent with the predicate devices.

#### Conclusion as to Substantial Equivalence

Laboratory testing was performed to support this claim of substantial equivalence and to show that the technological differences do not raise any new questions pertaining to effectiveness.

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Image /page/5/Picture/1 description: The image shows a circular logo with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized emblem resembling an eagle or bird in flight, composed of three curved lines that suggest feathers or wings. The logo is presented in black and white, with the text and emblem appearing in black against a white background.

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

Siemens Medical Solutions % Mr. Stefan Preiss Responsible Third Party Official TÜV Product Service 1775 Old Hwy 8 NW, Ste 104 NEW BRIGHTON MN 55112-1891

MAR 2 6 2007

Re: K070629

Trade/Device Name: Flex and Loop Coil Set 1.5T Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: II Product Code: MOS Dated: March 7, 2007 Received: March 7, 2007

Dear Mr. Preiss:

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 (Premarket Approval), 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.

Image /page/5/Picture/10 description: The image is a black and white circular logo. The logo contains the text "1886-1986" at the top, followed by the letters "PA" in a large, bold font. Below the letters, the word "Centennial" is written in a cursive font. There are four stars at the bottom of the logo. The logo appears to be a commemorative emblem for the centennial anniversary of an organization or event.

Protesting and Promoting Public Health

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Please be advised that FDA'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,

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 this letter:

| 21 CFR 876.xxx | (Gastroenterology/Renal/Urology) | 240-276-0115 |
|----------------|----------------------------------|--------------|
| 21 CFR 884.xxx | (Obstetrics/Gynecology) | 240-276-0115 |
| 21 CFR 894.xxx | (Radiology) | 240-276-0120 |
| Other | | 240-276-0100 |

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 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/cdrl/industry/support/index.html.

Sincerely vours.

Nancy C. Hogdon

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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## 2 Indications for Use Statement

510(k) Number (if known) _ K 070629

Device Name: Flex and Loop Coil Set 1.5 T

Indications for Use:

The intended use of the Flex and Loop Coil Set 1.5 T is, in conjunction with a Magnetic Resonance Scanner, the MR examination of the human body.

Used in the MAGNETOM Avanto, Espree and Symphony a Tim System, the Flex and Loop Coils are indicated for use as a diagnostic imaging device to produce transversal, sagittal, coronal and oblique images of the internal structures of the body. The images produced by the MAGNETOM Avanto, Espree and Symphony a Tim System with the Flex and Loop Coils reflect the spatial distribution of protons (hydrogen nuclei) exhibiting magnetic resonance.

When interpreted by a trained physician, these images provide information that can be useful in determining a diagnosis.

The intended use of the MAGNETOM Avanto, Espree and Symphony a Tim System is not affected in any way by the use of the new Flex and Loop Coil Set 1.5 T.

Prescription Use __ X (Part 21 CFR 801 Subpart D) Over-The-Counter Use

(21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

AND/OR

Concurrence of CDRH, Office of Device Evaluation (ODE)

Daniel h. Sepermm

sion of Reproductive, adiological Devices

Siemens 510(k) Premarket Notification

February 13, 2007

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