K232491
K232491
K232491
Re: K232491
Trade/Device Name: CT 5300
Regulation Number: 21 CFR 892.1750
Regulation Name: Computed Tomography X-Ray System
Regulatory Class: Class II
Product Code: JAK
Dated: April 4, 2024
Received: April 4, 2024
Dear An Shiguang:
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).
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 (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-reporting-
combination-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-devices/medical-device-safety/medical-device-reporting-
mdr-how-report-medical-device-problems.
For comprehensive regulatory information about medical devices and radiation-emitting products, including
information about labeling regulations, please see Device Advice (https://www.fda.gov/medical-
devices/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-devices/device-advice-comprehensive-regulatory-
assistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE
by email ([email protected]) 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 Radiologic Imaging
Devices and Electronic Products
OHT8: Office of Radiological Health
Office of Product Evaluation and Quality
Center for Devices and Radiological Health
Enclosure
DEPARTMENT OF HEALTH AND HUMAN SERVICES Form Approved: OMB No. 0910-0120
Food and Drug Administration Expiration Date: 07/31/2026
Indications for Use See PRA Statement below.
Device Name
CT 5300
These scanners are intended to be used for diagnostic imaging and for low dose CT lung cancer screening for the early
detection of lung nodules that may represent cancer*. The screening must be performed within the established inclusion
criteria of programs / protocols that have been approved and published by either a governmental body or professional
medical society.
*Please refer to clinical literature, including the results of the National Lung Screening Trial (N Engl J Med 2011;
365:395-409) and subsequent literature, for further information.
This section applies only to requirements of the Paperwork Reduction Act of 1995.
*DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*
The burden time for this collection of information is estimated to average 79 hours per response, including the
time to review instructions, search existing data sources, gather and maintain the data needed and complete
and review the collection of information. Send comments regarding this burden estimate or any other aspect
of this information collection, including suggestions for reducing this burden, to:
Department of Health and Human Services
Food and Drug Administration
Office of Chief Information Officer
Paperwork Reduction Act (PRA) Staff
[email protected]
“An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB number.”
FORM FDA 3881 (8/23) Page 1 of 1 PSC Publishing Services (301) 443-6740 EF
K232491
Traditional 510(k)
Summary of Clinical The proposed device did not require clinical study since
Data: substantial equivalence to the legally marketed predicate
device was proven with the verification/validation testing,
bench testing, retrospective clinical data, and other
evidence as outlined
Substantial Equivalence
Identical.
No. of Slices 64/128 64/128 Therefore, substantially
equivalent.
Surview Surview Identical.
Therefore, substantially
Scan Modes Axial Scan Axial Scan
equivalent.
Helical Scan Helical Scan
Minimum Scan 0.35 sec for 360° rotation 0.35 sec for 360° rotation Identical.
Time Therefore, substantially
equivalent.
Image (Spatial) High resolution mode: 16 High resolution mode: 16 Identical.
Resolution lp/cm lp/cm Therefore, substantially
equivalent.
Standard resolution Standard resolution
mode: 13 lp/cm mode: 13 lp/cm
Image Noise 0.27% at 120 kV, 230 0.27% at 120 kV, 230 Identical.
mAs, 10 mm slice mAs, 10 mm slice Therefore, substantially
equivalent.
thickness thickness
Therefore, substantially
equivalent.
Dose Reporting Compliance with NEMA Compliance with NEMA Compliance with more
NEMA standard.
and XR25, XR26, XR28 and XR25, XR28 and XR29
Management XR29 Safety and
effectiveness are not
affected.
Therefore,
demonstrating
substantial
equivalence.
Same feature
cleared in Conclusion
CT 5300
Predicate (Function/ User
Features Feature description
Philips interface/
Name
Incisive CT Workflow)
(K212441)
2D Viewer In 2D Viewer mode operator can review Yes Identical.
original axial images as acquired by the
Therefore,
scanner.
substantially
equivalent.
MPR Use the MPR mode to view three-plane Yes Identical.
orthogonal images. In this mode, the three Therefore,
shown planes can be easily correlated. substantially
Three orthogonal cut planes are shown: equivalent.
• Axial Orientation
• Coronal Orientation
• Sagittal Orientation