K982994 · Visualization Technology, Inc. · LLZ · Nov 16, 1998 · Radiology
Device Facts
Record ID
K982994
Device Name
SKULL BASE INSTATRAK SYSTEM
Applicant
Visualization Technology, Inc.
Product Code
LLZ · Radiology
Decision Date
Nov 16, 1998
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 892.2050
Device Class
Class 2
Indications for Use
The Skull Based InstaTrak System is intended for image guided assistance during skull base surgical procedures. It is intended to be used during skull base surgery involving procedures on the base of the brain (junction of the face and neurocranium).
Device Story
Image-guided surgical system; uses axial CT scans as input; electromagnetic tracking system correlates surgical instrument position to CT model; displays instrument tip as crosshairs in axial, coronal, and sagittal planes on monitor. Used in OR by surgeons to navigate skull base procedures; assists in avoiding critical nerves/anatomical structures. System includes head frame, transmitter arm, sterile pointers, and retractors. Provides pre-operative viewing, contextual pathology visualization, and intra-operative localization. Benefits patient by improving surgical precision and safety during complex skull base interventions.
Clinical Evidence
Bench testing only. Testing performed on new components to verify system accuracy; results confirmed device performance within specifications.
Technological Characteristics
Electromagnetic position sensing; Sun SPARC STATION computer; swiveling monitor; hard disk storage. Components include head frame, transmitter arm, extended straight sterile pointer, mouth gag, pharyngeal retractor, and nasal speculum. Software-based CT model reconstruction (axial to coronal/sagittal).
Indications for Use
Indicated for image-guided assistance during skull base surgical procedures involving the junction of the face and neurocranium.
Regulatory Classification
Identification
A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.
Special Controls
*Classification.* Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).
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510(k) Summary for Visualization Technology, Inc. Skull Base InstaTrak System
K982994
## 1. SPONSOR/APPLICANT NAME, ADDRESS
Visualization Technology, Inc. 200 Research Drive Wilmington, MA 01887
Contact Person:
Lewis J. Levine Director of Software Development (978) 933-1000 Telephone:
#### DATE OF SUMMARY PREPARATION:
August 26, 1998
- 2. DEVICE NAME
Skull Base InstaTrak System Proprietary Name: Common/Usual Name: Interactive CT Image Guided Surgical System Computed Tomography X-Ray System Classification Name:
## 3. IDENTIFICATION OF THE PREDICATE OR LEGALLY MARKETED DEVICE(S) TO WHICH EQUIVALENCE IS BEING CLAIMED
InstaTrak System, subject of K960330, the Pediatric InstaTrak System, subject of K981998 and the Viewing Wand manufactured by ISG Technologies, Inc., subject of K911783.
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#### 4. DEVICE DESCRIPTION
The InstaTrak System is an image guidance system indicated for use during skull base procedures. The Skull Base InstaTrak System is identical in principles of operation to the InstaTrak System cleared under K960330 and the Pediatric InstaTrak System cleared under K981998, which are indicated for use during nasal surgery. Using the Skull Base InstaTrak System, the surgeon can readily identify the immediate location and position of the surgical instrument during skull base procedures. The Skull Base InstaTrak System assists the surgeon in avoiding critical nerves and other anatomical structures. The Skull Base InstaTrak System includes several new components that were not included in K960330 or K981998, such as a head frame, transmitter arm, extended straight sterile pointer, mouth gag, pharyngeal retractor and nasal speculum. The remainder of the components used in the Skull Base System are identical to those described in the original submission. The additional components do not affect the overall operation of the system as the principles of operation are identical to that described in K960330. Like that system, the Skull Base InstaTrak System is an image guided surgery system that employs a computer with a top mounted swiveling monitor, software and an electromagnetic tracking system. The System uses a Sun SPARC STATION™. The System's proprietary software builds a CT model by taking axial CT images and reconstructing the coronal and sagittal views. The electromagnetic tracking system correlates the movement of surgical instruments to the CT model. The tip of the instrument is displayed as a set of cross hairs in the axial, coronal, and sagittal planes on the InstaTrak System monitor. With the InstaTrak System, CT images are used to assist the surgeon in guiding the position of the instrument during skull base surgery.
The Skull Base and InstaTrak Systems allow pre-operative viewing of the patients' CT images, contextual visualization of the pathology, intra-operative localization, screen display outputs for video recording and positional guidance. The system is operated by acquiring an axial CT scan while the patient wears the InstaTrak System headset and associated instruments. The axial images are then transferred via a network connection or cartridge to the InstaTrak System. The Headset position which stays fixed relative to the patients' anatomy, is automatically identified in the CT images by an image processing algorithm. Coronal and sagittal images are reconstructed and along with the Axial images, provide the CT model that will be used as a road map in surgery.
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### 5. INTENDED USE
The Skull Base InstaTrak System is an image guided device for use during skull base surgical procedures. It is intended to be used during skull Base surgery involving procedures on the base of the brain (junction of the face and neurocranium).
## 6. A STATEMENT OF HOW THE TECHNOLOGICAL CHARACTERISTICS OF THE DEVICE COMPARE TO PREDICATE OR LEGALLY MARKETED DEVICE(S) CITED
The Visualization Technology, Inc.'s Skull Base InstaTrak System is substantially equivalent to the Adult InstaTrak System, subject of K960330, and the Viewing Wand manufactured by ISG Technologies, Inc., subject of K911783.
The proposed Skull Base InstaTrak System and the ISG Technologies Viewing Wand devices are both intraoperative image-guidance systems intended for skull base surgery.
The Skull Base InstaTrak System is identical in technological characteristics to the InstaTrak System cleared under K960330. The Skull Base InstaTrak System uses electromagnetic position sensing, patient headset and automatic headset registration as the original InstaTrak.
The Skull Base InstaTrak System, the Adult InstaTrak System and the Viewing Wand all use a computer, monitor and hard disk storage system. The InstaTrak devices use an electromagnetic sensor to determine the location of the pointing instrument being used by the surgeon whereas the predicate ISG device uses a six-jointed, six-degree-offreedom mechanical articulated arm with an electro-goniometer, which functions as a 3-D digitizer.
Their are several new components in the Skull Base System as described in the Device Description Section of this submission. The new components include a nasal specula, mouth gag, pharyngeal retractor, straight extended aspirator, sterile disposable pointer, transmitter arm and head frame. The new components used in the Skull Base InstaTrak System have been added simply to accommodate the skull base surgical use. The nasal speculum, mouth gag, pharyngeal retractor are exempt from the 510(k) premarket notification process.
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# 7. FOR 510(k)S WHERE DETERMINATION OF EQUIVALENCE IS BASED ON PERFORMANCE DATA
Testing was performed using the new components of the Skull Base InstaTrak System to determine if the new components affected device accuracy. The results showed that the device performed within the specification while using the new components.
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Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services USA. The seal is circular, with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. In the center of the seal is a stylized design of three human profiles facing to the right, with flowing lines extending from the profiles.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
1 6 1998 NOV
Director of Software Development
Visualization Technology, Inc.
Lewis J. Levine
Re:
K982994 Skull Base InstaTrak System Dated: August 26, 1998 Received: August 27, 1998 Regulatory class: II 21 CFR 892.1750/Procode: 90 LLZ
Dear Mr. Levine:
200 Research Drive Wilmington, MA 01887
We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 Fecteral Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (OS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.
This letter will allow you to begin marketing your device as described in your 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 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address "http://www.fda.gov/cdrividsmadsmamain.html".
Sincerely yours,
Lillian Yih
Lillian Yin, Ph.D. Director, Division of Reproductive Abdominal, Ear, Nose and Throa and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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510(k) Number (if known): K 98 2994
Device Name: Visualization Technology, Inc. Skull Base InstaTrak System
Indications For Use:
The Skull Based InstaTrak System is intended for image guided assistance during skull base surgical procedures. It is intended to be used during skull base surgery involving procedures on the base of the brain (junction of the face and neurocranium).
(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NECESSARY)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Daniel G. Rogersm
(Division Sign-Off) Division of Reproductive, Abdominal, ENT, and Radiological Devices 510(k) Number
Prescription Use (Per 21 CFR 801.109) OR
8/26/98
Over-The-Counter Use
(Optional Format 1-2-96)
CONFIDENTIAL
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.