The intended use of the SIEMENS branded ARTISTE™, ONCOR™ and PRIMUS™ family of linear accelerator systems is to deliver X-Ray photon and electron radiation for the therapeutic treatment of cancer: COHERENCE™ RT Therapist is a component of the linear accelerator system and is based on the syngo® architecture. It enables patient management, patient selection/setup, patient positioning verification, treatment delivery/verification, and treatment recording. COHERENCE™ RT Therapist Workspace Connect v2.3 can be interfaced with 3rd party devices conforming to the DICOM standard.
Device Story
COHERENCE™ RT Therapist Connect Workspace v2.3 is a software component for Siemens linear accelerator systems (ARTISTE™, ONCOR™, PRIMUS™). It functions as a record-and-verify system, enabling patient management, setup, positioning verification, treatment delivery, and recording. It utilizes the proprietary syngo® software architecture to integrate clinical applications for patient set-up, treatment localization, and portal imaging. The system supports DICOM connectivity for integration with 3rd party Oncology Information Systems (OIS) via an optional low-voltage electronic switch. Operated by radiation therapists in a clinical setting, the software processes data to facilitate treatment workflows and ensure accurate delivery of radiation therapy. It benefits patients by providing a centralized, verified interface for managing complex radiotherapy procedures, reducing potential for manual error in treatment delivery.
Clinical Evidence
Bench testing only. Verification and validation were performed at the unit, integration, and system levels. Testing included regression testing of Control Console versions 9.2 and 11.0, and validation of the optional 3rd party OIS interface. All requirements in the Product Requirements Specifications (PRS) were successfully verified and traced in accordance with the Siemens product development lifecycle process (PDP).
Technological Characteristics
Software-based record-and-verify system utilizing proprietary syngo® architecture. Connectivity via DICOM standard. Includes optional low-voltage electronic switch for 3rd party OIS integration. Complies with IEC 60601-1-4 (Programmable Electrical Medical Systems), IEC 62304 (Software Life Cycle), IEC 61217 (Radiotherapy coordinates), and IEC 62274 (Record and Verify Systems).
Indications for Use
Indicated for patients requiring therapeutic treatment of cancer via X-Ray photon and electron radiation delivered by ARTISTE™, ONCOR™, or PRIMUS™ linear accelerator systems.
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
COHERENCE™ RT Therapist v2.1a with Control Console 9.2 (K090683)
ONCOR™ with 160MLC Option with RTT v2.2 & with Control Console 11.0 (K092145)
ONCOR™ Expression with RTT v2.0+ & with Control Console 9.0+ (K060226)
Submission Summary (Full Text)
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Siemens Medical Solutions USA, Inc. Radiation Oncology
K123812
Section 5
MAR 1 2013
Page Sect. 5/1
## 510(k) Summary
| Date Prepared:<br>Date Updated | | December 05, 2012<br>February 12, 2013 |
|--------------------------------|-------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------|
| Submitter: | | Siemens Medical Solutions USA, Inc.<br>Radiation Oncology<br>757A Arnold Drive<br>Martinez, CA 94553 |
| Contact: | Christine Dunbar<br>Senior Manager, Regulatory Affairs | |
| Phone:<br>Fax:<br>Email: | (925)293-5442<br>(925)602-8019<br>christine.dunbar@siemens.com | |
| Proprietary Name: | COHERENCE™ RT Therapist Connect Workspace, v2.3<br>And the optional 3rd party OIS Connectivity System | |
| Common Name: | Accessory To; Medical Charged-Particle Radiation Therapy System | |
| Classification: | 892.5050 | |
| Product Code: | IYE | |
Substantial Equivalence Claimed To:
| Product | 510(k)<br>Clearance /<br>Date | Claim of Equivalence for: |
|----------------------------------------------------------------------------|--------------------------------|---------------------------------------------------------------------------------------------------------------------------------------|
| COHERENCE™ RT<br>Therapist v2.1a with<br>Control Console 9.2. | K090683 /<br>May 08,<br>2009 | COHERENCE™ RT Therapist Connect Workspace, for<br>RT Therapist with Software update Sys_VA32a (RTTC<br>v2.3) and Control Console 9.2. |
| ONCOR™ with 160MLC<br>Option with RTT v2.2 & with<br>Control Console 11.0. | K092145 /<br>March 13,<br>2009 | COHERENCE™ RT Therapist Connect Workspace for<br>RT Therapist with Software update Sys_VA32a (RTTC<br>v2.3) and Control Console 11.0. |
| ONCOR™ Expression with<br>RTT v2.0+ & with Control<br>Console 9.0+ | K060226 /<br>Mar. 15,<br>2006 | COHERENCE™ RT Therapist Connect Workspace for<br>RT Therapist with Software update Sys_VA32a (RTTC<br>v2.3) and Control Console 9.2. |
The update to the COHERENCE™ RT Therapist Connect Workspace, v2.3 as described in this premarket notification has the same intended use and fundamental scientific technical characteristics as the predicate devices listed above.
## Description Summary
COHERENCE™ RT Therapist Connect Workspace, v2.3:
510(k) for SIEMENS COHERENCE™ RT Therapist Connect Update +30 Party OIS
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## Technological Characteristics:
The COHERENCE™ RT Therapist Connect Workspace v2.3 release is intended to update
customers with the currently released COHERENCE™ RT Therapist Connect Workspace with versions v2.1a (ONCOR / PRIMUS systems). The technological characteristics of the COHERENCE™ RT Therapist Connect Workspace v2.3 remain unchanged from the currently cleared products.
#### The syngo® Software Architecture:
The COHERENCE™ RT Therapist Connect software utilizes the proprietary syngo® software architecture design provides a method of delivering customized software applications based on the modality as clinically supporting packages. From these applications SIEMENS utilizes, as part of the Oncology clinical focus package, multiple applications for patient set-up and position verification, treatment localization, treatment verification, portal imaging as well as data processing, image reformatting, display and printing. The currently cleared COHERENCE™ and syngo@ products also include an array of image-oriented software tools, support for DICOM connectivity, Siemens Remote Service, and virus protection features.
#### General Safety and Effectiveness:
The device labeling contains instructions for use and any necessary cautions and warnings, to provide for safe and effective use of the device.
Risk management is ensured via a risk analysis, which is used to identify potential hazards and mitigations. These potential hazards are controlled by software means, user instructions, verification of requirements and validation of the clinical workflow to ensure that the product meets its intended uses. To minimize electrical, mechanical and radiation hazards, SIEMENS adheres to recognized and established industry practice and relevant international standards.
#### Intended Use:
The intended use of the SIEMENS branded ARTISTE™, ONCOR™ and PRIMUS™ family of linear accelerator systems is to deliver X-Ray photon and electron radiation for the therapeutic treatment of cancer:
COHERENCE™ RT Therapist is a component of the linear accelerator system and is based on the syngo® architecture. It enables patient management, patient selection/setup, patient positioning verification, treatment delivery/verification, and treatment recording.
COHERENCE™ RT Therapist Workspace Connect v2.3 can be interfaced with 3rd party devices conforming to the DICOM standard.
### Substantial Equivalence:
The Substantial Equivalence comparison chart demonstrates the comparison of the technological characteristics of the COHERENCE™ RT Therapist Connect Workspace v2.3 update to the currently cleared predicate devices.
510(k) for SIEMENS COHERENCE™ RT Therapist Connect Update +310 Party OIS
{2}------------------------------------------------
The COHERENCE™ RT Therapist Connect Workspace v2.3, does not change the intended use of the original COHERENCE™ RT Therapist Connect Workspace v2.1a or the Siemens branded Linear Accelerator Systems.
#### Bench Testing:
Bench testing in the form of Unit, Integration and System Integration testing was performed to evaluate the performance and functionality of the software update v2.3 for the RT Therapist Connect and regression testing the Control Console, versions 9.2 and 11.0. All testable requirements in the Product Requirements Specifications (PRS) for the Sys_VA32a project, and additionally the specific requirements for the implementation of the third party OIS marketed by have been successfully verified and traced in accordance with the Siemens product development (lifecycle) process (PDP).
The software verification and regression testing has been performed successfully to meet their previously determined acceptance criteria.
#### Non-Clinical Test Results:
Validation of the COHERENCE™ RT Therapist Connect Workspace v2.3, implementation of the optional third party OIS with the low voltage electronic switch and regression testing with Control Consoles 9.2.18 and 11.0.212 has been performed at the System test level on production prototype devices by appropriately trained and knowledgeable test personnel. System level validation and regression testing has been performed successfully, demonstrating that the software meets the acceptance criteria as noted in the system test plans.
#### Testing to Consensus Standards:
The COHERENCE™ RT Therapist Connect Workspace, v2.3, Control Console and the new electronic switch to support the third party OIS implementation have been tested to meet the requirements for conformity (where applicable) to the following standards:
- IEC 60601-1-4:1996+ A1: 1999 Medical Electrical Equipment: Part 1-4: General . requirements for Collateral Standard: Programmable Electrical Medical Systems
- IEC 62304:2006 Medical Device Software Software Life Cycle Processes ●
- IEC 61217 (2007), Radiotherapy equipment Coordinates, movements, and scales .
- IEC 62274:2005 Medical Electrical Equipment, Safety of Radiotherapy Record and . Verify Systems
### Substantial Equivalence to Predicates:
The verification testing to the Product requirements for the AT Therapist Connect workspace, validation of the intended use, and the regression testing to the existing RT Therapist Connect software and Control Console functional requirements, is intended to support the claim of substantial equivalence to the following predicates:
- The COHERENCE™ RT Therapist Connect v2.1a. & CC 9.2 (K090683), .
- The ONCOR with 160MLC option with the RTT v2.2 & CC 11.0 (K092145) and ◆
510(k) for SIEMENS COHERENCE™ RT Therapist Connect Update +31d Party OIS Page Sect. 5/3
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. The ONCOR and PRIMUS with the RTT v2.0 and 2.1 & CC 9.0+(K060226) Summary:
In summary, it is SIEMENS' opinion that the COHERENCE™ RT Therapist Connect Workspace v2.3 update including the optional 30 party OIS Connectivity systems requiring the low voltage electronic switch where configured, does not introduce any new potential safety risks and is substantially equivalent to, and performs as well as, the predicate devices.
Image /page/3/Picture/4 description: The image shows the text "Page Sect. 5/4" on the top line and "0026" on the second line. The top line appears to indicate a page and section number, while the second line likely represents a document or record identifier. The text is written in a clear, legible font, making it easy to read. The image is likely a snippet from a larger document or record.
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#### DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/4/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a stylized eagle with its wings spread, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the eagle. The eagle is black, and the text is also black.
#### Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
March 1, 2013
Christine Dunbar Senior Manager, Regulatory Affairs Siemens Medical Solutions USA, Inc. Radiation Oncology 757A Arnold Drive MARTINEZ CA 94553
Re: K123812
Trade/Device Name: COHERENCE™ RT Therapist Connect Workspace Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: December 7. 2012 Received: January 15, 2013
#### Dear Ms. Dunbar:
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.
{5}------------------------------------------------
Page 2-Ms. Dunbar
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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 Small Manufacturers, International and Consumer Assistance 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,
Michaela Hara
for Janine M. Morris, M.S. Director, Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health
Enclosure
{6}------------------------------------------------
# Indications for Use
510(k) Number (if known): K123812
Device Name: COHERENCETM RT Therapist Connect Workspace, v2.3
Indications for Use:
The intended use of the SIEMENS branded ARTISTE™, ONCOR™ and PRIMUS™ family of linear accelerator systems is to deliver X-Ray photon and electron radialion for the therapeulic treatment of cancer.
COHERENCE™ RT Therapist is a component of the linear accelerator system and is based on the syngo@ architecture. It enables patient management, patient selection/selup, palient positioning verification, treatment delivery/verification, and treatment recording.
COHERENCE™ RT Therapist Workspace Connect v2.3 can be Interfaced with 3rd party devices conforming to the DICOM standard.
Prescription Use (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)
Mehta
(Division Sign Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health
510(k)
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Learn the FDA Browser
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.