← Product Code [KPS](/productcode/KPS) · K012775

# GE POSITRACE/DISCOVERY VI PET/CT DUAL MODE ONCOLOGY SCANNER (K012775)

_GE Medical Systems · KPS · Sep 18, 2001 · Radiology · SESE_

**Canonical URL:** https://fda-staging.innolitics.com/device/K012775

## Device Facts

- **Applicant:** GE Medical Systems
- **Product Code:** [KPS](/productcode/KPS.md)
- **Decision Date:** Sep 18, 2001
- **Decision:** SESE
- **Submission Type:** Special
- **Regulation:** 21 CFR 892.1200
- **Device Class:** Class 2
- **Review Panel:** Radiology

## Indications for Use

Combination of whole-body positron emission tomography (PET) scanning with a diagnostic quality computed tomography scanner. Intended for use as a diagnostic imaging device. Used with appropriate radiopharmaceuticals, it produces images which depict the anatomical distribution of radioisotopes within the human body. The integrated il produced in intended to provide an enhancement to the emission images by compensating for the attenuation of byothing intended to provide registration of anatomical and physiological images to localize the radioisotope activity in the patient anatomy. The CT or PET scanner may be used independently.

## Device Story

Whole-body PET/CT scanner for oncology applications; consists of patient table, PET scanner, CT scanner, UNIX workstation, monitor, keyboard, mouse, modem, and network interface. Device acquires PET emission data and CT transmission data; transforms inputs into registered anatomical and physiological images. Integrated system uses CT data to compensate for PET attenuation; provides anatomical localization of radioisotope activity. Operated by clinical staff in a diagnostic imaging environment. Output viewed by physicians on workstation monitor to assist in clinical decision-making and oncology diagnosis. Benefits include improved localization of radioisotope activity through image registration and attenuation correction.

## Clinical Evidence

No clinical data. Bench testing only; device evaluated for electrical and radiation safety, conforming to applicable medical device safety standards.

## Technological Characteristics

Integrated PET/CT system. Components: patient table, PET scanner, CT scanner, UNIX workstation. Connectivity: network interface, modem. Standards: 21 CFR 892.1200 (Emission Computed Tomography), 21 CFR 892.1750 (Computed Tomography X-Ray System). Quality systems: 21 CFR 820, ISO 9001, EN 46001.

## Regulatory Identification

An emission computed tomography system is a device intended to detect the location and distribution of gamma ray- and positron-emitting radionuclides in the body and produce cross-sectional images through computer reconstruction of the data. This generic type of device may include signal analysis and display equipment, patient and equipment supports, radionuclide anatomical markers, component parts, and accessories.

## Predicate Devices

- Positrace Dual Mode PET/CT Oncology System ([K001681](/device/K001681.md))

## Submission Summary (Full Text)

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K012775

SEP 1 8 2001

# Attachment B Summary of Safety and Effectiveness

Prepared in accordance with 21 CFR Part 807.92(c).

GE Medical Systems

General Electric Company 8380 Darrow Road, Twinsburg, OH 44087

| Submitter:           | GE Medical Systems - SMV<br>8380 Darrow Road<br>Twinsburg, OH 44087                                                                                                                                                                                           |
|----------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person:      | Geoff Cochrane<br>Manager, Engineering<br>Telephone: 330-487-6638; Fax: 330-405-7684                                                                                                                                                                          |
| Date Prepared:       | 09-Aug-2001                                                                                                                                                                                                                                                   |
| Device Name:         | Positrace / Discovery VI Dual Mode PET/CT Oncology System<br>Emission Computed Tomography System, 21 CFR 892.1200, 90-KPS                                                                                                                                     |
| Marketed Device:     | Positrace Dual Mode PET/CT Oncology System, 510(k) Number K001681, currently in<br>commercial distribution.                                                                                                                                                   |
| Device Description:  | The Positrace / Discovery VI PET/CT scanner is a whole-body scanner primarily<br>intended for oncology applications. It consists of a patient table, PET scanner, CT<br>scanner, UNIX workstation, monitor, keyboard, mouse, modem, and network<br>interface. |
| Indications for Use: | Combination of whole-body positron emission tomography (PET) scanning with a<br>diagnostic quality computed tomography scanner. Intended for use as a diagnostic<br>imaging device.                                                                           |

Comparison with Predicate Device: The Positrace / Discovery VI is of a comparable type and substantially equivalent to the currently marketed Positrace scanner. It has the same technological characteristics, is comparable in key safety and effectiveness features, uses the same basic design, and has the same intended uses as the predicate device.

Summary of Studies: The device has been evaluated for electrical, and radiation safety, and conforms with applicable medical device safety standards.

#### Clinical Tests: None required.

Conclusion: Intended uses and other key features are consistent with traditional clinical practice, FDA guidelines, and established methods of patient examination. Intended uses and fundamental scientific technology are the same as the legally marketed Positrace scanner. The design and development process of the manufacturer conforms with 21 CFR 820, ISO 9001 and EN 46001 quality systems. The device conforms to applicable medical device safety standards and compliance is verified through independent evaluation with factory surveillance. Therefore, it is the opinion of GE Medical Systems that the Positrace / Discovery VI scanner is substantially equivalent with respect to safety and effectiveness to devices currently cleared for market.

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Image /page/1/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines forming its body and head. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the emblem.

#### Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Geoffrey Cochrane Engineering Manager GE Medical Systems General Electric Company 8380 Darrow Road TWINSBURG OH 44087 SEP 1 8 2001

Re: K012775

Trade/Device Name: GE Positrace/Discovery VI PET/CT Dual Mode Oncology Scanner Regulation Number: 21 CFR 892.1200 Regulation Name: Emission Computed Tomography System Product Code: 90 KPS Regulation Number: 21CFR 892.1750 Regulation Name: Computed Tomography X-Ray System Product Code: 90 JAK Regulatory Class: II Dated: August 9, 2001 Received: August 20, 2001

Dear Mr. Cochrane:

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 10 more carrer to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); 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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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), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

| 8xx.1xxx                         | (301) 594-4591 |
|----------------------------------|----------------|
| 876.2xxx, 3xxx, 4xxx, 5xxx       | (301) 594-4616 |
| 884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx | (301) 594-4616 |
| 892.2xxx, 3xxx, 4xxx, 5xxx       | (301) 594-4654 |
| Other                            | (301) 594-4692 |

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 Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Nancy C. Brogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Special 510(k) Premarket Notification GE Medical Systems - Positrace / Discovery VI Oncology Scanner 09-Aug-2001

#### STATEMENT OF INTENDED USE

510(k) Number (if known):

K012775

Device Name: Discovery VI Dual Mode PET / CT Oncology System

## Indications for Use

Combination of whole-body positron emission tomography (PET) scanning with a diagnostic quality computed tomography scanner. Intended for use as a diagnostic imaging device. Used with appropriate radiopharmaceuticals, it produces images which depict the anatomical distribution of radioisotopes within the human body. The integrated il produced in intended to provide an enhancement to the emission images by compensating for the attenuation of byothing intended to provide registration of anatomical and physiological images to localize the radioisotope activity in the patient anatomy. The CT or PET scanner may be used independently.

### (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(Per 21 CFR 801-109) ✓

OR Over-The-Counter Use_

Nancy L. Broadrick

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