K232147 · Pie Medical Imaging BV · QHA · Apr 9, 2024 · Radiology
Device Facts
Record ID
K232147
Device Name
CAAS Workstation
Applicant
Pie Medical Imaging BV
Product Code
QHA · Radiology
Decision Date
Apr 9, 2024
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 892.1600
Device Class
Class 2
Attributes
Software as a Medical Device
Indications for Use
CAAS Workstation is a modular software product intended to be used by or under supervision of a cardiologist or radiologist in order to aid in reading and interpreting cardiovascular X-Ray images to support diagnoses and for assistance during intervention of cardiovascular conditions.
Device Story
CAAS Workstation is a client-server image post-processing software for cardiology/radiology. It ingests DICOM X-ray angiographic images from PACS or acquisition systems. Using semi-automatic contour detection, it performs 3D reconstruction of vessels and catheter paths. Workflows include StentEnhancer (stent visualization/measurement) and vFFR (pressure drop quantification). Operated via keyboard, mouse, or touchscreen on Windows PCs in clinical environments. Results are displayed, printed, or exported to PACS/network. It aids clinicians in diagnosing and intervening in cardiovascular conditions by providing quantitative measurements of vessel structures and stenosis, supporting clinical decision-making.
Clinical Evidence
Bench testing only. Verification and validation confirmed system requirements and risk controls were implemented correctly. Performance testing compared numerical results of StentEnhancer and vFFR workflows against the predicate, showing comparable outputs. Usability testing per IEC 62366-1 confirmed user ability to perform intended tasks.
Technological Characteristics
Client-server software running on Windows OS. Supports DICOM connectivity. Features semi-automatic contour detection for 3D vessel reconstruction. Standards: ISO 13485, ISO 14971, IEC 62304, IEC 62366-1, IEC 82304-1, ISO 15223-1. Operates via keyboard, mouse, or touchscreen.
Indications for Use
Indicated for cardiologists or radiologists to segment cardiovascular structures, perform 3D reconstruction of vessel segments and catheter paths from angiographic images, calculate cardiovascular dimensions, quantify coronary stenosis, determine optimal C-arm positioning, quantify coronary pressure drop, and enhance/measure stents.
Regulatory Classification
Identification
An angiographic x-ray system is a device intended for radiologic visualization of the heart, blood vessels, or lymphatic system during or after injection of a contrast medium. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.
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April 9, 2024
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Pie Medical Imaging B.V. % Annemiek Bouts Regulatory Affairs Coordinator Philipsweg 1 Maastricht, Limburg 6227 AJ NETHERLANDS
# Re: K232147
Trade/Device Name: CAAS Workstation Regulation Number: 21 CFR 892.1600 Regulation Name: Angiographic X-Ray System Regulatory Class: Class II Product Code: QHA, LLZ Dated: March 7, 2024 Received: March 7, 2024
# Dear Annemiek Bouts:
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 (the 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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.
Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).
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Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).
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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Lu Jiang
Lu Jiang, Ph.D. Assistant Director Diagnostic X-Ray Systems Team DHT8B: Division of Radiological Imaging Devices and Electronic Products OHT8: Office of Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health
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# Indications for Use
510(k) Number (if known) K232147
Device Name CAAS Workstation
#### Indications for Use (Describe)
CAAS Workstation features segmentation of cardiovascular structures, 3D reconstruction of vessel segments and catheter path based on multiple angiographic images, measurement and reporting tools to facilitate the following use:
- · Calculate the dimensions of cardiovascular structures;
- · Quantify stenosis in coronary vessels;
- · Determine C-arm position for optimal imaging of cardiovascular structures;
- · Quantify pressure drop in coronary vessels;
- · Enhance stent visualization and measure stent dimensions;
CAAS Workstation is intended to be used by or under supervision of a cardiologist.
| 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)
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## 510(k) Summary
## CAAS Workstation
Pie Medical Imaging BV
| I – General Information | | |
|-------------------------|----------------------------------------------------------------------------------|----------------------------------------|
| Submitter/Owner Name | Pie Medical Imaging BV | |
| Address | Philipsweg 1, 6227 AJ Maastricht, The Netherlands | |
| Phone Number | +31 43 32 81 328 | |
| Contact Person | Annemiek Bouts, Regulatory Affairs Coordinator | |
| Email Address | reg@pie.nl | |
| Date | 08-Apr-24 | |
| Trade/Device Name | CAAS Workstation | |
| Classification | Common Name: | Radiological Image Processing Software |
| | Regulation Class: | Class II |
| | Regulation Description: | Angiographic X-Ray System |
| | Regulation number: | 21 CFR 892.1600 |
| | Classification Product Code: | QHA |
| | Additional Product Code: | LLZ |
| Predicate Device | CAAS Workstation (K180019, Angiographic X-ray System, 21 CFR 892.1600, QHA, LLZ) | |
## Il - Device Description
CAAS Workstation is an image post-processing software package for advanced visualization and ysis in the field of cardiology or radiology and offers functionality to view X-Ray angiographic images, to segment cardiovascular structures in these images, to analyze and quantify these cardiovascular structures and to present the results in different formats.
CAAS Workstation is a client-server solution intended for usage in a network environment or standalone usage and runs on a PC with a Windows operating system. It can read DICOM X-ray images from a directory, or receive DICOM images from the X-ray or PACS system.
CAAS Workstation is composed out of the following analysis workflows: StentEnhancer and vFFR for calculating dimensions of coronary vessels, quantification of stenosis and calculating the pressure drop and vFFR value based on two 2D X-Ray angiographic images. Semi-automatic contour detection forms the basis for the analyses.
Results can be displayed on the screen, printed or saved in a variety of formats to hard disk, network, PACS system or CD. Results and clinical images with overlay can also be printed as a hardcopy and exported in various electronic formats. The functionality is independent of the type of vendor acquisition equipment.
## III - Intended Use and Indications for Use
### Intended Use
CAAS Workstation is a modular software product intended to be used by or under supervision of a cardiologist or radiologist in order to aid in reading and interpreting cardiovascular X-Ray images to support diagnoses and for assistance during intervention of cardiovascular conditions.
### Indications for Use
CAAS Workstation features segmentation of cardiovascular structures, 3D reconstruction of vessel segments and catheter path based on multiple angiographic images, measurement and reporting tools to facilitate the following use:
- Calculate the dimensions of cardiovascular structures;
- Quantify stenosis in coronary vessels;
- Determine C-arm position for optimal imaging of cardiovascular structures;
- Quantify pressure drop in coronary vessels;
- Enhance stent visualization and measure stent dimensions;
CAAS Workstation is intended to be used by or under supervision of a cardiologist.
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# IV - Substantial equivalence
CAAS Workstation (K180019) is selected as a predicate device has technological features and characteristics comparable to the new CAAS Workstation and is intended to be used by or under supervision of a cardiologist or radiologist to support clinical decision making of cardiovascular conditions.
Predicate device, CAAS Workstation (K180019), is an earlier version of the new CAAS Workstation product. It provides similar functionalities by means of the analysis workflows StentEnhancer and vFFR for calculating dimensions of cardiovascular structures, quantify stenosis in coronary vessels, determine C-arm position for optimal imaging of cardiovascular structures, quantify pressure drop in coronary vessels (all part of vFFR workflow) and enhance stent visualization and measure stent dimensions (StentEnhancer workflow). All these functionalities are also supported in the new CAAS Workstation product. Other technological features available in predicate device K180019: the analysis workflows QCA, QVA, QCA3D, LVA, RVA and IV-LINQ are not present in the new CAAS Workstation product.
The other differences in technological characteristics between the predicate device K180019 and the device CAAS Workstation are that the new CAAS Workstation runs from a browser and the server-side installation can be on the system itself (standalone usage) or on a server accessible through the intranet (network environment). Predicate device K180019 is only a standalone usage device. Additionally, CAAS Workstation can be operated using keyboard, mouse and touchscreen while predicate device K180019 could only be operated using the keyboard and mouse.
New technological characteristics in the vFFR workflow in CAAS Workstation include a change in the default lesion location from minimum diameter location towards the largest percentage stenosis location and a correction for the hydrostatic pressure as a function of elevation in the pressure drop quantification.
The basic features and technology of the new CAAS Workstation are the same in terms of intended use and indications for use and have the similar technological characteristics as the predicate device CAAS Workstation (K180019). The cardiovascular functions supported by the new CAAS Workstation are also provided by the predicate device K180019. Both software applications use the same types of data and operating principles for the user and technology regarding data import, contour definition, image display and storage of results.
## V - Performance Data
Verification and validation of the new CAAS Workstation showed that the system requirements – derived from the intended use and indications for use – as well as risk control measures were implemented correctly and that the device meets its specifications including conformance to the following international standards (i.e., ISO13485, ISO14971, IEC 62304, IEC 62366-1, IEC 82304-1, and ISO 15223-1).
Performance testing demonstrated that the numerical results for the analysis workflows StentEnhancer and vFFR, as already available in predicate device K180019, were comparable.
Usability testing is performed in accordance with the IEC 62366-1 standard and demonstrated that the user is able to use CAAS Workstation for the purpose it was developed for.
All verification and validation results demonstrate the safety and effectiveness of CAAS Workstation in relation to its intended use and therefore CAAS Workstation can be considered as safe and effective as its predicate device.
# VI - Conclusion
Based on the application of risk management and performance testing inherent to PMI's QA system (compliant with recognized standards as stated above) CAAS Workstation is as safe and effective as its predicate device in terms of intended use, indications for use, technological characteristics, measurements and does not raise any new issues related to safety and effectiveness compared to the predicate device.
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.