K172188 · Toshiba Medical Systems Coroporation · JAK · Oct 6, 2017 · Radiology
Device Facts
Record ID
K172188
Device Name
Aquilion Prime SP, TSX-303B/1, v8.4
Applicant
Toshiba Medical Systems Coroporation
Product Code
JAK · Radiology
Decision Date
Oct 6, 2017
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 892.1750
Device Class
Class 2
Indications for Use
This device is indicated to acquire and display cross-sectional volumes of the whole body, to include the head. The Aquilion Prime SP has the capability to provide volume sets. These volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician.
Device Story
80-row CT system; acquires cross-sectional whole-body images. Inputs: X-ray signals processed via PURE Vision detector and DAS board. Operation: Physician-operated in clinical settings; utilizes PURE Vision Optics (wedge filters) for optimized beam spectrum. Outputs: Cross-sectional volume sets for diagnostic review. Workflow enhancements include variable helical pitch, dual-energy packages, and metal artifact reduction. Benefits: Improved image quality, dose reduction (20-31%), and faster reconstruction speeds compared to predicate. Healthcare providers use output for specialized diagnostic studies; supports clinical decision-making through high-resolution imaging.
Clinical Evidence
Bench testing only. Evaluated spatial resolution, slice thickness, CT number uniformity, noise, and low-contrast detectability (LCD). Dose reduction study (AIDR 3D Enhanced) supported 51%–75% reduction. PURE Vision Optics study showed 20%–31% dose reduction, 13%–19% LCD improvement (head), 15%–22% LCD improvement (body), and 13% noise reduction. Representative diagnostic images reviewed by a board-certified radiologist confirmed diagnostic quality.
Technological Characteristics
80-row CT system; 896 channels x 80 rows; 0.5 mm detector elements. Hexa-core Xeon processor, 32GB+ RAM. PURE Vision Optics (wedge filters). Connectivity: DICOM (NEMA PS 3.1-3.18). Standards: IEC 60601-1, 60601-1-2, 60601-2-44, NEMA XR-25/26/29. Software: Moderate level of concern.
Indications for Use
Indicated for whole-body cross-sectional imaging, including the head, for use by trained and qualified physicians.
Regulatory Classification
Identification
A computed tomography x-ray system is a diagnostic x-ray system intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data from the same axial plane taken at different angles. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.
Predicate Devices
Aquilion PRIME, TSX-303A/A, /B and /F, v6.00 (K141741)
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Toshiba Medical Systems Corporation % Orlando Tadeo, Jr. Regulatory Affairs Manager Toshiba America Medical Systems, Inc. 2441 Michelle Drive TUSTIN CA 92780
October 6, 2017
# Re: K172188
Trade/Device Name: Aquilion Prime SP, TSX-303B/1, v8.4 Regulation Number: 21 CFR 892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: II Product Code: JAK Dated: July 19, 2017 Received: July 20, 2017
Dear Mr. Tadeo:
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 of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 (DICE) 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. 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 (DICE) 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,
Michael D. O'Hara For
Robert Ochs. Ph.D. 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)
K172188
Device Name
Aquilion Prime SP, TSX-303B/1, v8.4
#### Indications for Use (Describe)
This device is indicated to acquire and display cross-sectional volumes of the whole body, to include the head.
The Aquilion Prime SP has the capability to provide volume sets. These volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician.
Type of Use (Select one or both, as applicable)
ال Prescription Use (Part 21 CFR 801 Subpart D)
_ Over-The-Counter Use (21 CFR 801 Subpart C)
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#### FOR FDA USE ONLY
Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
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## 510(k) SUMMARY
- 1. SUBMITTER'S NAME: Toshiba Medical Systems Corporation 1385 Shimoishigami Otawara-Shi, Tochigi-ken, Japan 324-8550
- 2. OFFICIAL CORRESPONDENT: Naofumi Watanabe Senior Manager, Regulatory Affairs and Vigilance
- 3. ESTABLISHMENT REGISTRATION: 9614698
## 4. CONTACT PERSON:
Orlando Tadeo, Jr. Manager, Regulatory Affairs Toshiba America Medical Systems, Inc 2441 Michelle Drive Tustin, CA 92780 (714) 669-7459
- 5. Date Prepared:
September 27, 2017
- 6. TRADE NAME(S): Aquilion Prime SP, TSX-303B/1, v8.4
- 7. COMMON NAME: System, X-ray, Computed Tomography
- 8. DEVICE CLASSIFICATION: Class II (per 21 CFR 892.1750)
- 9. PRODUCT CODE / DESCRIPTION: JAK – System, Computed Tomography
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2441 Michelle Drive, Tustin, CA 92780 / 800.421.1968 / medical.toshiba.com
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### 10. PERFORMANCE STANDARD:
This device conforms to applicable Performance Standards for Ionizing Radiation Emitting Products [21 CFR, Subchapter J, Part 1020]
#### 11. PREDICATE DEVICE:
| Product | Marketed by | 510(k) Number | Clearance Date |
|-------------------------------------------------------------------------------|------------------------------------|---------------|-------------------|
| Aquilion PRIME,<br>TSX-303A/A, /B and /F, v6.00<br>(Primary Predicate Device) | Toshiba America<br>Medical Systems | K141741 | November 11, 2014 |
| Aquilion Lightning SP<br>TSX-036A/1, v8.4 | Toshiba America<br>Medical Systems | K170019 | February 2, 2017 |
#### 12. REASON FOR SUBMISSION:
Modification of a cleared device
#### 13. DEVICE DESCRIPTION:
The Aquilion Prime SP TSX-303B/1 is an 80-row CT System that is intended to acquire and display cross-sectional volumes of the whole body, including the head. This system is based upon the technology and materials of previously marketed Toshiba CT systems.
### 14. INDICATIONS FOR USE:
This device is indicated to acquire and display cross-sectional volumes of the whole body, to include the head.
The Aquilion Prime SP has the capability to provide volume sets. These volume sets can be used to perform specialized studies, using indicated software, by a trained and qualified physician.
#### 15. SUBSTANTIAL EQUIVALENCE:
The subject device is substantially equivalent to the Aquilion PRIME, TSX-303A/A, /B and /F v6.00, which received premarket clearance under K141741 and is marketed by Toshiba America Medical Systems. The Aquilion Prime SP TSX-303B/1, v8.4, incorporates modifications to the cleared device which include changes to the current detector (new wedge filter and new DAS board), modifications to previously cleared optional software applications in order to realize workflow improvements and addition of previously cleared optional software features. These changes do not affect the safety or efficacy of the cleared device, as demonstrated in performance testing. The method of operation and manufacturing process remain unchanged from the cleared device. See below for a brief comparison of the technological characteristics between the subject and the predicate devices:
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| Item | Aquilion Prime SP<br>TSX-303B/1, v8.4 | Aquilion PRIME<br>TSX-303A/A,/B and /F, v6.00 |
|--------------------------------------------------------------|--------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------|
| 510(k) Number | This submission | K141741 |
| Detector | 896 channels × 80 rows<br><span style="font-size: smaller;">PURE Vision</span> | 896 channels × 80 rows<br><span style="font-size: smaller;">PURE Vision</span> |
| Number of detector<br>elements | 0.5 mm x 80 rows | 0.5 mm x 80 rows |
| Maximum scan<br>length/rotation | 40 mm/rotation | 40 mm/rotation |
| FOV (Field of View) | 320/500 mm<br>in diameter | 180/240/320/400/500 mm<br>in diameter |
| Wedge filter types | Two types | Three types |
| <span style="font-size: smaller;">PURE</span> Vision Optics* | Standard | N/A |
| Processing capability | Hexa-core Xeon<br>32GB memory or more | Quad-core Xeon<br>12GB memory or more |
| Image reconstruction time<br>(Max. speed) | Up to 50 images/s (0.02 s/image)<br>Up to 70 images/s (0.014 s/image)<br>* with optional upgrade | Up to 30 images/s (0.033 s/image)<br>Up to 60 images/s (0.016 s/image)<br>* with optional upgrade |
| Extended Field of View | Available | Not Available |
# Modifications to previously cleared software options:
| Application | Comment |
|---------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Variable Helical Pitch (vHP) | Workflow improvements: 3-phase vHP available<br>and for ECG-gated helical scan phase, Modulation<br>can be specified and SUREExposure3D is enabled.<br>Previously cleared under K170019 |
| Dual Energy System Package | Workflow improvement: DE clinical application<br>can be executed during scanning.<br>Previously cleared under K170019 |
| SEMAR<br>(Single Energy Metal Artifact Reduction) | Implementation of Volume ECG-gated scan,<br>previously cleared under K170019 |
# Previously cleared software options being implemented to the modified device:
| 4D Cerebral Artery Morphological Analysis | Previously cleared under K142465 |
|-------------------------------------------|----------------------------------|
| SURE Subtraction Lung | Previously cleared under K133324 |
| Scan Protocol Management | Previously cleared under K142465 |
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*PURE Vision Optics, based upon the new wedge filters in combination with the PUREVision detector, afford the system with an optimized beam spectrum and the filtration of low energy photons for a more homogeneous x-ray spectrum. Previously cleared under K170177
## 16. SAFETY:
The device is designed and manufactured under the Quality System Regulations as outlined in 21 CFR § 820 and ISO 13485 Standards. This device is in conformance with the applicable parts of the IEC60601-1, IEC60601-1-1, IEC60601-1-2, IEC60601-1-4, IEC60601-1-6, IEC60601-1-6, IEC60601-2-28, IEC60601-2-32, IEC60601-2-44, IEC60825-1, IEC62304, IEC62366, NEMA PS 3.1-3.18, NEMA XR-25 NEMA XR-26 and NEMA XR-29. Additionally, this device complies with all applicable requirements of the radiation safety performance standards, as outlined in 21 CFR §1010 and §1020.
## 17. TESTING
Risk analysis and verification/validation testing conducted through bench testing are included in this submission which demonstrates that the requirements for the modifications made to the system have been met. The modified system was evaluated to assess spatial resolution, axial slice thickness/slice sensitivity profile, CT number magnitude/uniformity, noise properties, low contrast detectability and contrast-to-noise ratio performance and it was determined that the subject device demonstrates equivalent or slightly improved image quality characteristics.
## Quantitative Dose Reduction and Spatial Resolution Evaluation
A dose reduction study was conducted using AIDR 3D Enhanced and based on the results, a dose reduction claim with the range 51% to 75% is supported while simultaneously preserving low contrast detectability and high contrast spatial resolution
## PURE ViSION Optics Quantitative LCD and Noise Improvement
Studies were conducted comparing the subject device with PURE Vision Optics versus the predicate device to assess dose reduction and LCD/Noise improvements using filtered backprojection (FBP) on both systems. The results of the studies demonstrated a quantitative dose reduction of 20%-31%, improvements in low contrast detectability for head (range 13%-19%), improvements in low contrast detectability for body (range 15%-22%) and noise reduction of 13% at the same dose as evaluated via model observer studies (MITA-FDA LCD Head and MITA-FDA LCD Body phantoms).
Representative diagnostic images, reviewed by an American Board Certified Radiologist, including head, chest, abdomen and peripheral exams were also obtained using the subject device which demonstrates that the device produces images of diagnostic quality and; therefore, performs as intended.
Software Documentation for a Moderate Level of Concern, per the FDA guidance document, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices Document" issued on May 11, 2005, is included as part of this submission.
Cybersecurity documentation, per the FDA cybersecurity premarket guidance document "Content of Premarket Submissions for Management of Cybersecurity in Medical Devices " issued on October 2, 2014, is also included as part of this submission.
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Additionally, testing of the modified system was conducted in accordance with the applicable standards published by the International Electrotechnical Commission (IEC) for Medical Devices and CT Systems.
## 18. CONCLUSION
The modifications incorporated into the Aquilion Prime SP TSX-303B/1, v8.4 do not change the indications for use or the intended use of the device. Based upon bench testing, representative clinical images, successful completion of software validation and application of risk management and design controls, it is concluded that the subject device has demonstrated substantial equivalence to the predicates and is safe and effective for its intended use.
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.