K140528 · Varian Medical Systems, Inc. · IYE · Sep 5, 2014 · Radiology
Device Facts
Record ID
K140528
Device Name
TRUE BEAM, TRUE BEAM STX, EDGE
Applicant
Varian Medical Systems, Inc.
Product Code
IYE · Radiology
Decision Date
Sep 5, 2014
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 892.5050
Device Class
Class 2
Attributes
Therapeutic, Pediatric
Indications for Use
The TrueBeam and Edge Systems are intended to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors, and conditions anywhere in the body where radiation therapy is indicated for adults and pediatric patients.
Device Story
Medical linear accelerator system; delivers photon, electron, and diagnostic kV X-ray radiation; installed in radiation-shielded vault with external control console. Used by clinicians for stereotactic radiosurgery and precision radiotherapy. Integrates functionality of previously cleared Trilogy system. Device operates by generating radiation beams to treat tumors and lesions; clinical staff use system to plan and deliver targeted radiation therapy. Benefits include precise treatment of various malignancies and benign conditions throughout the body.
Clinical Evidence
No clinical data; no new testing performed as the device is unchanged from the previously cleared predicate.
Technological Characteristics
Medical linear accelerator; photon, electron, and diagnostic kV X-ray radiation sources. System consists of radiation-producing component for shielded vault and external control console. Same technological characteristics as K123291.
Indications for Use
Indicated for adults and pediatric patients requiring stereotactic radiosurgery or precision radiotherapy for lesions, tumors, and conditions anywhere in the body, including brain, spine, head and neck, thoracic, gynecologic, gastrointestinal, genitourinary, breast, skin, and pediatric tumors, as well as benign diseases and metastases.
Regulatory Classification
Identification
A medical charged-particle radiation therapy system is a device that produces by acceleration high energy charged particles (e.g., electrons and protons) intended for use in radiation therapy. This generic type of device may include signal analysis and display equipment, patient and equipment supports, treatment planning computer programs, component parts, and accessories.
Predicate Devices
TrueBeam Radiotherapy System and Accessories (K123291)
CyberKnife Robotic Radiosurgery System and CyberKnife VSI Systems (K102650)
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
September 5, 2014
Varian Medical Systems, Inc. % Mr. Peter J. Coronado Director, Global Regulatory Affairs 3100 Hansen Way PALO ALTO CA 84304
Re: K140528
Trade/Device Name: TrueBeam, TrueBeam STx, Edge Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: July 31, 2014 Received: August 4, 2014
Dear Mr. Coronado:
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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
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 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to
http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
Michael D'Hara
For
Janine M. Morris Director Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known) K140528
#### Device Name
TrueBeam and Edge Radiotherapy Delivery System
#### Indications for Use (Describe)
The TrueBeam and Edge Systems are intended to provide stereotactic radiotherapy for lesions, and conditions anywhere in the body where radiation therapy is indicated for adults and pediatric patients.
The TrueBeam and Edge Systems may be used in the delivery of radiation for treatment that includes: bram and spine tumors (such as glioma, meningioma, craniopharyngioma, pituitary tumors, spinal cord tumors, hemangioblastoma, orbital tumors, optic nerve tumors, and skull based tumors (such as unknown primary of the head and neck, oral cavity, hypopharynx, larynx, oropharynx, sinonasal, salivary gland, and thyroid cancer), thoracic tumors (such as ung cancer, esophageal cancer, thymic tumors, and mesothelioma), gynecologic tumors (such as ovarian, endometrial, vulvar, and vaginal), gastrointestinal tumors (such as gastric, hepatobiliary, colon, rectal, and anal carvinoma), genitourinary tumors (such as prostate, bladder, testicular, and kidney), breast tumors, sarcomas, lymphoid tumors (such as Hodgkin's lymphoma), skin cancers (such as squamous cell, and melanoma), benign diseases (such as schwannoma, arteriovenous malformation, cavemous malformation, trigeninal neuralgia, chordoma, glomus tumors, and hemangiomas), metastasis (including all parts of the body such as brain, bone, liver, lung, kidney, and skin) and pediatric tumors (such as glioma, pitutary tumors, hemangioblastoma, craniopharyngioma, metastasis, medulloblastoma, nasopharyngeal tumors, arteriovenous malformation, cavernous malformation and skull base tumors).
Type of Use (Select one or both, as applicable)
X | Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
### PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
#### FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
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Varian Medical Systems, Inc. 3100 Hansen Way Palo Alto, CA 94304-1038 USA Tel +1 650 493 4000 www.varian.com
# Premarket Notification [510(k)] Summary
# TrueBeam/Edge Radiotherapy Delivery Systems
The following information is provided following the format of 21 CFR 807.92(c).
| Submitter's Name: | Varian Medical Systems, Inc.<br>3100 Hansen Way E-110<br>Palo Alto, CA 94304<br><br>Contact Name: Peter J. Coronado<br>Phone: 650.424.6320<br>Fax: 650.646.9200<br><br>Date: 31 July 2014 |
|-----------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Proprietary Name: | TrueBeam™/ TrueBeam STx™ Radiotherapy Delivery System<br>Edge™ Radiotherapy Delivery System |
| Classification Name: | Medical charged-particle radiation therapy system<br>21 CFR 892.5050, Class II<br>Product Code: IYE |
| Common/Usual Name: | Medical linear accelerator |
| Predicate Devices: | TrueBeam Radiotherapy System and Accessories: K123291<br>CyberKnife Robotic Radiosurgery System and CyberKnife VSI Systems:<br>K102650<br>Agility™ K123808 |
| Device Description: | The TrueBeam™ and Edge™ Radiotherapy Delivery Systems are medical linear<br>accelerators that integrate the previously cleared Trilogy Radiotherapy system<br>and associated accessories into a single device.<br><br>The system consists of two major components, a photon, electron, and<br>diagnostic kV X-ray radiation beam-producing component that is installed in a<br>radiation-shielded vault and a control console area located outside the<br>treatment room. |
| Intended Use<br>Statement | The TrueBeam and Edge Systems are intended to provide stereotactic<br>radiosurgery and precision radiotherapy for lesions, tumors, and conditions<br>anywhere in the body where radiation therapy is indicated for adults and<br>pediatric patients. |
| Indications for Use<br>Statement | The TrueBeam and Edge Systems are intended to provide stereotactic<br>radiosurgery and precision radiotherapy for lesions, tumors, and conditions<br>anywhere in the body where radiation therapy is indicated for adults and<br>pediatric patients.<br><br>The TrueBeam and Edge Systems may be used in the delivery of radiation for<br>treatment that includes: brain and spine tumors (such as glioma, meningioma,<br>craniopharyngioma, pituitary tumors, spinal cord tumors, hemangioblastoma,<br>orbital tumors, ocular tumors, optic nerve tumors, and skull based tumors),<br>head and neck tumors (such as unknown primary of the head and neck, oral<br>cavity, hypopharynx, larynx, oropharynx, nasopharynx, sinonasal, salivary<br>gland, and thyroid cancer), thoracic tumors (such as lung cancer, esophageal<br>cancer, thymic tumors, and mesothelioma), gynecologic tumors (such as<br>ovarian, cervical, endometrial, vulvar, and vaginal), gastrointestinal tumors<br>(such as gastric, pancreatic, hepatobiliary, colon, rectal, and anal carcinoma),<br>genitourinary tumors (such as prostate, bladder, testicular, and kidney),<br>breast tumors, sarcomas, lymphoid tumors (such as Hodgkin's and non-<br>Hodgkin's lymphoma), skin cancers (such as squamous cell, basal cell, and<br>melanoma), benign diseases (such as schwannoma, arteriovenous<br>malformation, cavernous malformation, trigeminal neuralgia, chordoma,<br>glomus tumors, and hemangiomas), metastasis (including all parts of the body<br>such as brain, bone, liver, lung, kidney, and skin) and pediatric tumors (such as<br>glioma, ependymoma, pituitary tumors, hemangioblastoma,<br>craniopharyngioma, meningioma, metastasis, medulloblastoma,<br>nasopharyngeal tumors, arteriovenous malformation, cavernous<br>malformation and skull base tumors). |
| Technological<br>Characteristics | This device has the same technological characteristics as the previously<br>cleared TrueBeam device K123291. This submission does not introduce any<br>device modifications. |
| Substantial<br>Equivalence | The indication for use statement for the TrueBeam and Edge radiotherapy<br>delivery systems is similar but not identical to its primary predicate device<br>K123291. The changes made with this submission include specific indications<br>for some typical lesions, tumors and conditions that may be treated with<br>radiation. The addition of this text to the indication statement does not<br>change the therapeutic effect of the device. These treatment sites fall within<br>the previously cleared general indication “to provide stereotactic radiosurgery<br>and precision radiotherapy for lesions, tumors, and conditions anywhere in<br>the body where radiation therapy is indicated”. The device itself is unchanged<br>from the previous submission K123291. The principles of operation,<br>technological characteristics and labeling are substantially equivalent.<br><br>The functionality and intended use of the TrueBeam and Edge systems is<br>substantially equivalent to that of its predicate devices, CyberKnife and<br>CyberKnife VSI Systems (K102650) and Agility™ K123808, in safety and<br>effectiveness. |
| Summary of<br>performance testing | No changes have been made to the device and no new testing has been<br>performed. |
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Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.