FDA-cleared profile

iCAC Device

Bunkerhill, Inc

Authorized purpose: Adjunctive opportunistic coronary-calcium estimation during routine chest CT review, providing informational segmentation and Agatston estimates for physician assessment rather than a stand-alone diagnosis.

Evidence status: each field states its source quality, applicability, and review date. Research pending, information not established, and vendor documentation pending remain distinct outcomes.

Product overview

Start with the essentials

Authorized purpose: Adjunctive opportunistic coronary-calcium estimation during routine chest CT review, providing informational segmentation and Agatston estimates for physician assessment rather than a stand-alone diagnosis.

Overview status: Source-reviewed overview

Clinical takeaway

Clinical role: Adjunctive opportunistic coronary-calcium estimation during routine chest CT review, providing informational segmentation and Agatston estimates for physician assessment rather than a stand-alone diagnosis.

Evidence takeaway

Evidence from the reviewed source record: FDA validation used 762 paired studies from nine geographically diverse sites. Overall category alignment was 79.7%, and category-level positive predictive value ranged from 68.1% to 90.1%; the submission acceptance criteria were at least 73% alignment and at least 65% PPV for each category.

Clinical details

What this tool is for

Start with the authorized purpose, then verify how it fits your service line and reading workflow.

Exact purpose
Adjunctive opportunistic coronary-calcium estimation during routine chest CT review, providing informational segmentation and Agatston estimates for physician assessment rather than a stand-alone diagnosis.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Intended users
Qualified medical professionals, including radiologists and interpreting physicians.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Care setting and population
Medical facilities providing routine-care non-gated, non-contrast chest CT and physician interpretation.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Workflow role
Adjunctive informational support for radiologist review in the standard workflow; the original patient report and CT remain available and physician review is required.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Required input
Adult non-gated, non-contrast chest CT scans in DICOM format, transferred from an imaging database such as PACS or a DICOM router; the labeled age is 30 years and above.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Output and human action
An informational visual representation of estimated coronary-artery-calcium segmentation plus exact and four-category quantitative estimates of coronary calcium burden in Agatston units, viewable in the patient report and diagnostic image viewer.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Limitations
The cleared input is routine non-gated, non-contrast chest CT in patients aged 30 years and above. Results are informational and not intended for stand-alone clinical decision-making; the reviewed FDA validation used paired non-gated chest CT and gated coronary CT studies and should not be generalized beyond the described population and workflow.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07

Regulatory identity

FDA record and catalog context

The FDA listing establishes the regulatory identity. It does not by itself establish local workflow fit, pricing, security, or performance in your environment.

FDA submission
K230223
  • FDA source
  • Exact FDA submission
  • Checked 2026-08-31
Modality
CT/CTA
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Anatomy
Heart/Cardiovascular
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Clearance type
510(k)
  • FDA source
  • Exact FDA submission
  • Checked 2026-08-31
Decision date
2023-04-25
  • FDA source
  • Exact FDA submission
  • Checked 2026-08-31
FDA status
FDA-cleared
  • FDA source
  • Exact FDA submission
  • Checked 2026-08-31

Implementation

Questions for IT, informatics, and operations

Use these fields to structure a vendor demo, security review, and implementation estimate.

Integration
The standalone SaMD receives DICOM from PACS or a DICOM router and can present the estimated score or category in a patient report, the segmentation in a diagnostic viewer, and an optional DICOM Secondary Capture series.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Deployment and data flow
On-premise
  • Public source
  • Exact FDA submission
  • Checked 2026-08-13

Deployment category preserved from the prior exact-submission review; hosting region, data flow, and current commercial configuration still require vendor confirmation.

Security and privacy
Vendor documentation pending
  • Vendor confirmation
  • Exact FDA submission
  • Checked 2026-09-07

The reviewed sources do not establish exact-release security controls, retention or assurance documentation.

Training and support
Vendor documentation pending
  • Vendor confirmation
  • Exact FDA submission
  • Checked 2026-08-13

Training, onboarding, competency, and support commitments are commercial implementation details that require current vendor documentation.

Monitoring and change control
Vendor documentation pending
  • Vendor confirmation
  • Exact FDA submission
  • Checked 2026-08-13

Local acceptance testing, production monitoring, drift review, update control, and incident escalation require a current vendor and site-specific governance plan.

PACS or DICOM-router input

The cleared standalone SaMD receives routine non-gated, non-contrast chest CT through DICOM transfer from an imaging database such as PACS or a DICOM router and can return report, viewer and optional DICOM Secondary Capture outputs.

exact submission · checked 2026-09-07

Carebricks CAC workflow context

Bunkerhill states that its current Carebricks product uses the FDA-cleared iCAC algorithm to detect and quantify CAC on routine non-gated chest CT and describes follow-up prioritization and care coordination for health systems.

product family · checked 2026-09-07

This vendor announcement supports current family workflow context; it does not establish exact K230223 release performance, installation, price, security or support terms.

Evidence

Performance evidence

Metrics are shown only when they are tied to a source, endpoint, population, and tested product version. Candidate literature without exact product and version linkage is not shown as product evidence.

Evidence summary
FDA validation used 762 paired studies from nine geographically diverse sites. Overall category alignment was 79.7%, and category-level positive predictive value ranged from 68.1% to 90.1%; the submission acceptance criteria were at least 73% alignment and at least 65% PPV for each category.
  • FDA source
  • Exact FDA submission
  • Checked 2026-09-07
Reported sensitivity
Not established in reviewed sources
  • Reviewed sources checked
  • Exact FDA submission
  • Checked 2026-09-07

The FDA summary reports alignment and PPV for calcium categories rather than a disease-detection sensitivity measure.

Reported specificity
Not established in reviewed sources
  • Reviewed sources checked
  • Exact FDA submission
  • Checked 2026-09-07

The FDA summary reports alignment and PPV for calcium categories rather than a disease-detection specificity measure.

Overall category alignment

0.797 proportion

  • EndpointOverall alignment between estimated coronary calcium category and paired reference
  • Population762 paired non-gated non-contrast chest CT and gated coronary CT studies from nine geographically diverse sites
  • Tested versioniCAC Device configuration submitted in K230223

Category PPV lower endpoint

0.681 proportion

  • EndpointLowest reported positive predictive value among the four calcium categories
  • Population762 paired non-gated non-contrast chest CT and gated coronary CT studies from nine geographically diverse sites
  • Tested versioniCAC Device configuration submitted in K230223

Category PPV upper endpoint

0.901 proportion

  • EndpointHighest reported positive predictive value among the four calcium categories
  • Population762 paired non-gated non-contrast chest CT and gated coronary CT studies from nine geographically diverse sites
  • Tested versioniCAC Device configuration submitted in K230223

iCAC Device paired-study validation

  • DesignRetrospective paired-study validation comparing routine non-gated, non-contrast chest CT estimates with paired gated coronary CT reference categories and Agatston measurements.
  • Population762 paired CT studies from nine geographically diverse sites, with the calcium categories represented in the validation set.
  • Scopeexact submission
  • Tested versioniCAC Device configuration submitted in K230223
  • Samplen=762
  • Sites9
  • IndependenceSponsor or vendor study

K230223

The lower and upper PPV values are endpoints of the reported category span, not a single across-case range metric or a full-paper clinical-outcomes study.

Costs and setup

Budget and ongoing governance

These are common procurement questions; unknown values remain visible until a source supports them.

Pricing and total cost
Vendor documentation pending
  • Vendor confirmation
  • Exact FDA submission
  • Checked 2026-09-07

No public price or quote for the exact K230223 configuration was reviewed.

Reimbursement and coding
Research pending
  • Needs research
  • Exact FDA submission
  • Checked 2026-09-07

Payer policy research was outside this worker's scope.

Safety and lifecycle

Postmarket record

Recall and adverse-event records are shown only after product matching. Adverse-event reports do not establish incidence or causality.

Postmarket safety review
Not established in reviewed sources
  • Reviewed sources checked
  • Exact FDA submission
  • Checked 2026-09-07

The exact-ID recall packet contained zero records; this limited result does not establish absence of recall or safety information.

Buyer worksheet

Open questions to take to the vendor

Open evaluation checklist

Research record

What has been checked

This audit distinguishes completed source review from fields that have not yet been researched.

Exact FDA record reviewedStatus
2026-09-07Last searched
23Fields reviewed
10Source classes checked
20Screened PubMed leads
10Screened trial leads
0Unreviewed FDA recall leads

Stored candidate metadata was screened. The broad iCAC query returned 20 PubMed and 10 trial identifiers without exact K230223 linkage established in metadata; no full paper or trial record was reviewed, and no candidate is promoted as product evidence. The current discovery snapshot contains 20 PubMed and 10 ClinicalTrials.gov candidate records; its dated, count-matched human screening remains current. Unlinked candidates remain quarantined. Native FDA recall identifiers produced 0 postmarket candidate records; 0 have been reviewed (0 published, 0 rejected) and 0 remain unreviewed.

Candidate leads were screened against the exact product and tested version. Unlinked records remain quarantined.

Source classes: fda ai list, fda decision summary, acr ai central product, vendor announcement, stored candidate metadata, literature index, trial registry, pubmed, clinical trials, openfda device recall

Sources & history

How this profile was documented

Open the ledger for source dates, scope, and research-record updates.

View source ledger and history

Source ledger

  1. FDA 510(k) K230223: iCAC Device

    U.S. Food and Drug Administration - Published 2023-04-25 - Accessed 2026-09-07

    Scope: identity, clinicalUse, modality, anatomy, workflow, evidence, implementation

  2. Artificial Intelligence-Enabled Medical Devices

    U.S. Food and Drug Administration - Accessed 2026-08-31

    Scope: regulatoryIdentity, modalityContext

  3. iCAC Device model card (K230223)

    American College of Radiology - Published 2026-08-17 - Accessed 2026-09-01

    Scope: purpose, modality, intendedUsers, careSetting, output, limitations, evidenceSummary, integration, anatomy, evidenceStudies, implementationCapabilities

  4. PubMed biomedical literature index

    U.S. National Library of Medicine - Accessed 2026-09-01

    Scope: evidenceDiscovery

  5. ClinicalTrials.gov study registry

    U.S. National Library of Medicine - Accessed 2026-09-01

    Scope: evidenceDiscovery, studyStatus

  6. openFDA Device Recall API

    U.S. Food and Drug Administration - Accessed 2026-09-02

    Scope: recallDiscovery, nativeSubmissionMatching

  7. Bunkerhill and Cleerly strategic partnership for iCAC

    Bunkerhill Health - Published 2025-03-04 - Accessed 2026-09-08

    Scope: productFamily, implementationCapabilities

Research history

  1. K230223 FDA decision

    Regulatory record

    510(k)

  2. Source-review record updated

    Research record

    fda record reviewed

  3. Reader overview source-reviewed

    Editorial review

    Source-reviewed editorial overlay

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