1.5T 32-CHANNEL HEAD COIL AND 3T 32-CHANNEL HEAD COIL

K072909 · Siemens AG Medical Solutions · MOS · Oct 31, 2007 · Radiology

Device Facts

• Record ID: K072909
• Device Name: 1.5T 32-CHANNEL HEAD COIL AND 3T 32-CHANNEL HEAD COIL
• Applicant: Siemens AG Medical Solutions
• Product Code: MOS · Radiology
• Decision Date: Oct 31, 2007
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.1000
• Device Class: Class 2
• Attributes: 3rd-Party Reviewed

Intended Use

The intended uses of the 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil are, in conjunction with a Magnetic Resonance Scanner, the MR examination of the human head. Used in the 1.5 T MAGNETOM Avanto, MAGNETOM Espree or MAGNETOM Symphony, a Tim System, the 1.5 T 32-channel Head Coil and in the 3 T MAGNETOM Trio, a Tim System, the 3T 32-channel Head Coil are indicated for uses 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 1.5 T MAGNETOM Avanto, MAGNETOM Espree or MAGNETOM Symphony, a Tim System with the 1.5 T 32-channel Head Coil and the images produced by the 3 T MAGNETOM trio a Tim System with the 3T 32-channel Head Coil 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, MAGNETOM Espree or MAGNETOM Symphony a Tim System is not affected in any way by the use of the new 1.5T 32-channel Head Coil. The intended use of the MAGNETOM Trio a Tim System is not affected in any way by the use of the new 3T 32-channel Head Coil.

Device Story

Receive-only MR head coils; 1.5T and 3T variants; split design for patient positioning; includes patient comfort mirror. 32 receive elements enable high acceleration factors via parallel imaging (iPAT). Used in clinical radiology settings; operated by trained MR technicians/physicians. Input: MR signals from human head. Output: MR images/spectra displayed on scanner console. Physician interprets images to assist in diagnosis. Benefits: optimized signal-to-noise ratio (SNR) compared to previous matrix coils; enables faster imaging via iPAT.

Clinical Evidence

Bench testing only. Performance evaluated via Signal to Noise Ratio (SNR) and image uniformity testing in accordance with IEC 62464-1 standard. Results demonstrate equivalence to predicate devices.

Technological Characteristics

Receive-only MR head coils; 32-channel array; split-design form factor. Connectivity: interfaces with Siemens MAGNETOM scanner systems. Standards: IEC 62464-1 for performance testing. No new materials compared to predicates.

Indications for Use

Indicated for MR examination of human head to produce cross-sectional images (transverse, sagittal, coronal, oblique) of internal structures for diagnostic purposes. Used with specific Siemens MAGNETOM scanner systems. Contrast agents may be used.

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

• Siemens MAGNETOM Avanto 1.5T (Head MATRIX coil) (K032428)
• Siemens MAGNETOM Trio a Tim System 3T (Head MATRIX coil) (K050200)

Submission Summary (Full Text)

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K072909
Page 1 of 3

Section 5: 510(k) Summary

# 5 510(k) Summary

OCT 3 : 2007

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of Safe Medical Device Act 1990 and 21 CFR § 807.92.

#### General Information I.

Date of summary preparation: August 24", 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. Lutz Mahn Regulatory Affairs Manager Henkestrasse 127 D-91052 Erlangen, Germany Phone: [phone] Fax: [phone] e-mail: [e-mail]

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KC729C9
Page 2 of 3

### Section 5: 510(k) Summary

| 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: | Volume Coil |
| Trade Name: | 1.5 T 32-channel Head Coil<br>3 T 32-channel Head Coil |

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

#### Intended Use

The 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil are indicated for use as magnetic resonance diagnostic devices (MRDD) that produces transverse, sagittal, coronal and oblique cross sectional images, spectroscopic images and/or spectra, and that display the internal structure and/or function of the head. Depending on the region of interest, contrast agents may be used. These images and/or spectra when interpreted by a trained physician yield information that may assist in diagnosis.

#### Device Description

The 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil are receive only MR coils

Image /page/1/Picture/8 description: The image shows a white object against a black background. The object appears to be a piece of equipment or machinery, possibly a component of a larger system. The object has a rounded shape with some linear features and protrusions on the sides. Due to the high contrast and lack of detail, it is difficult to determine the exact nature or function of the object.

for imaging the human head. The coils comprises a split design for easy patient positioning. An addition mirror is provided for patient comfort. A high number of 32 receive elements has been chosen to make use of high acceleration factors in the so-called parallet imaging technique (iPAT). The inner dimensions of the coil have been chosen to be smaller than the Head Matrix Coil to optimize the signal-tonoise ratio.

#### Substantial Equivalence

Siemens believes that the 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil are substantially equivalent to the following cleared medical devices:

| Predicate Device Name | FDA Clearance Number | FDA Clearance Date |
|----------------------------------------------------------------|----------------------|--------------------|
| Siemens MAGNETOM Avanto<br>1.5T<br>(Head MATRIX coil) | K032428 | Oct 16, 2003 |
| Siemens MAGNETOM Trio a Tim System<br>3T<br>(Head MATRIX coil) | K050200 | Feb 28, 2005 |

#### General Safety and Effectiveness Concerns:

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K072909
Page 3 of 3

## Section 5: 510(k) Summary

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 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil

- [Safety] - Biocompatibility
[Performance] - Signal to Noise Ratio - Image Uniformity

No new materials were used for the new 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil compared to their predicate device. Therefore no new biocompatibility tests were performed. Signal to Noise Ratio (SNR) and image uniformity tests acc. to IEC 62464-1 standard were performed for the new 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil 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/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, with wavy lines below them.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

### OCT 3 1 2007

Siemens AG Medical Solutions c/o Mr. Stefan Preiss Responsible Third Party Official TÜV SÜD America, Inc. 1775 Old Highway 8, Suite 104 NEW BRIGHTON MN 55112-1891

Re: K072909

Trade/Device Name: 1.5T 32-channel Head Coil and 3T 32-channel Head Coil Regulation Number: 21 CFR §892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: II Product Code: MOS Dated: October 8, 2007 Received: October 12, 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 (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.

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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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter.

| 21 CFR | Description | Number |
|-----------------|----------------------------------|--------------|
| 21 CFR 876.xxxx | (Gastroenterology/Renal/Urology) | 240-276-0115 |
| 21 CFR 884.xxxx | (Obstetrics/Gynecology) | 240-276-0115 |
| 21 CFR 892.xxxx | (Radiology) | 240-276-0120 |
| Other | | 240-276-0100 |

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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/cdrh/industry/support/index.html.

Sincerely yours,

Nancy 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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# 4 Indications for Use Statement

510(k) Number (if known)

1.5T 32-channel Head Coil and 3T 32-channel Head Coil

Device Name: 1.5T 32-channel Head Coil and 3T 32-channel Head Coil

Indications for Use:

The intended uses of the 1.5T 32-channel Head Coil and the 3T 32-channel Head Coil are, in conjunction with a Magnetic Resonance Scanner, the MR examination of the human head.

Used in the 1.5 T MAGNETOM Avanto, MAGNETOM Espree or MAGNETOM Symphony, a Tim System, the 1.5 T 32-channel Head Coil and in the 3 T MAGNETOM Trio, a Tim System, the 3T 32-channel Head Coil are indicated for uses 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 1.5 T MAGNETOM Avanto, MAGNETOM Espree or MAGNETOM Symphony, a Tim System with the 1.5 T 32-channel Head Coil and the images produced by the 3 T MAGNETOM trio a Tim System with the 3T 32-channel Head Coil 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, MAGNETOM Espree or MAGNETOM Symphony a Tim System is not affected in any way by the use of the new 1.5T 32-channel Head Coil.

The intended use of the MAGNETOM Trio a Tim System is not affected in any way by the use of the new 3T 32-channel Head Coil.

(Please do not write below this line- continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation

| Prescription Use | <u>X</u> |
|------------------|-----------------------------|
| OR | Over-The-Counter Use ______ |

| | <div>(Division Sign-Off)</div> <div>Division of Reproductive, Abdominal and Radiological Devices</div> |
|--|--------------------------------------------------------------------------------------------------------|
|--|--------------------------------------------------------------------------------------------------------|

| Siemens 510(k) Premarket Notification | August 24, 2007 |
|---------------------------------------|-----------------|
| 510(k) Number | K072909 |