FDA-cleared profile

Koios DS

Koios Medical, Inc.

Koios Decision Support (DS) is an artificial intelligence (AI)/machine learning (ML)-based computer-aided diagnosis (CADx) software device intended for use as an adjunct to diagnostic ultrasound examinations of lesions or nodules suspicious for breast or thyroid cancer. Koios DS allows the user to select or confirm regions of interest (ROIs) within an image representing a single lesion or nodule to be analyzed. The software then automatically characterizes the selected image data to generate an AI/MLderived cancer risk assessment and selects applicable lexicon-based descriptors designed to improve overall diagnostic accuracy as well as reduce interpreting physician variability. Koios DS software may also be used as an image viewer of multi-modality digital images, including ultrasound and mammography. The software includes tools that allow users to adjust, measure and document images, and output into a structured report. Koios DS software is designed to assist trained interpreting physicians in analyzing the breast ultrasound images of adult (>= 22 years) female patients with soft tissue breast lesions and/or thyroid ultrasounds of all adult (>= 22 years) patients with thyroid nodules suspicious for cancer. When utilized by an interpreting physician who has completed the prescribed training, this device provides information that may be useful in recommending appropriate clinical management.

Evidence status: each field shows source quality, applicability, and review date. Research pending, information not established in reviewed sources, and vendor documentation pending are distinct outcomes.

Clinical fit

What this tool is for

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

Exact purpose
Koios Decision Support (DS) is an artificial intelligence (AI)/machine learning (ML)-based computer-aided diagnosis (CADx) software device intended for use as an adjunct to diagnostic ultrasound examinations of lesions or nodules suspicious for breast or thyroid cancer. Koios DS allows the user to select or confirm regions of interest (ROIs) within an image representing a single lesion or nodule to be analyzed. The software then automatically characterizes the selected image data to generate an AI/MLderived cancer risk assessment and selects applicable lexicon-based descriptors designed to improve overall diagnostic accuracy as well as reduce interpreting physician variability. Koios DS software may also be used as an image viewer of multi-modality digital images, including ultrasound and mammography. The software includes tools that allow users to adjust, measure and document images, and output into a structured report. Koios DS software is designed to assist trained interpreting physicians in analyzing the breast ultrasound images of adult (>= 22 years) female patients with soft tissue breast lesions and/or thyroid ultrasounds of all adult (>= 22 years) patients with thyroid nodules suspicious for cancer. When utilized by an interpreting physician who has completed the prescribed training, this device provides information that may be useful in recommending appropriate clinical management.
FDA source Exact FDA submission Checked 2026-09-08
Intended users
Radiologist
Public source Exact FDA submission Checked 2026-09-01

Intended-user text reported in the exact-submission ACR model card.

Care setting and population
Adult
Public source Exact FDA submission Checked 2026-09-01

Patient-population text reported in the exact-submission ACR model card; institutional setting may still require vendor confirmation.

Workflow role
Measurement or quantification
Public source Exact FDA submission Checked 2026-08-31

Conservative normalization of explicit wording in an exact-submission source.

Required input
Ultrasound images or data involving Breast; consult the FDA labeling for exact protocol, series, and quality requirements.
Public source Exact FDA submission Checked 2026-08-31

Conservative normalization of explicit wording in an exact-submission source.

Output and human action
Koios DS software automatically classifies breast lesions suspicious for cancer based on image data into one of four ACR BI-RADS® Atlas1 or European U1-U5 Classification System-aligned categories (Benign, Probably Benign, Suspicious or Indeterminate, or Probably Malignant) and also displays a continuous graphical Confidence Level Indicator depicting where the lesion falls within its respective category and its relation to neighboring categories. The software automatically classifies the shape (Round, Oval, Irregular) and orientation (Parallel, Not Parallel) of the selected lesion.
Public source Exact FDA submission Checked 2026-09-01

Clinical output reported in the exact-submission ACR model card.

Limitations
Exclusion criteria: Non-DICOM or non-ultrasound images; modalities other than ultrasound (e.g., mammography, CT, MRI); images with severe artifacts that preclude adequate assessment. More extensive information regarding data that is not compatible with Koios is available in the 'Warning' section of the User Guide
Public source Exact FDA submission Checked 2026-09-01

Limitations and supported-acquisition details reported in the exact-submission ACR model card.

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
K242130
FDA source Exact FDA submission Checked 2026-08-31
Modality
Ultrasound
FDA source Exact FDA submission Checked 2026-09-08
Anatomy
Breast
FDA source Exact FDA submission Checked 2026-09-08
Clearance type
510(k)
FDA source Exact FDA submission Checked 2026-08-31
Decision date
2024-11-15
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 exact-submission ACR model card explicitly references DICOM in the described input, output, or workflow; exact interfaces, versions, and local compatibility require confirmation.
Public source Exact FDA submission Checked 2026-09-01

Interoperability terms explicitly reported in the exact-submission ACR model card; interface versions and local compatibility still require confirmation.

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 2026-09-08

Exact-release security controls, data retention, hosting boundaries, and scoped assurance documentation require vendor confirmation.

Training and support
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-09-08

Current training prerequisites, competency checks, and support commitments for the exact configuration require vendor confirmation.

Monitoring and change control
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-09-08

Current drift, quality, uptime, alert, escalation, and incident-response commitments for the exact configuration require vendor confirmation.

Input or output interoperability

DICOM is explicitly referenced in the described input, output, or workflow.

exact submission · checked 2026-09-01

The model card does not establish every supported DICOM object, transfer method, or local interface.

ACR exact-submission catalog context

ACR AI Central provides an exact-submission model card for Koios DS; FDA labeling remains controlling for clinical use, limitations, and performance.

exact submission · checked 2026-09-08

Evidence

Performance evidence

Metrics are shown only when they are tied to a source, endpoint, population, and tested product version.

Evidence summary
Study type: Reader Study. Cases: 900. Reference standard: null. Reader-study cases: 900. Readers: 15. Reader-study sensitivity: 97.6%. Reader-study specificity: 63.2%
Public source Exact FDA submission Checked 2026-09-01

Structured study metadata from the exact-submission ACR model card; this is not an independent evidence synthesis.

Reported sensitivity
1.6%; 94.5%; 0.511%
FDA source Exact FDA submission Checked 2026-08-13

Values reported in the exact-submission materials. Consult the linked source for endpoint, threshold, population, and confidence interval before comparison.

Reported specificity
2.2%; 18.741%
FDA source Exact FDA submission Checked 2026-08-13

Values reported in the exact-submission materials. Consult the linked source for endpoint, threshold, population, and confidence interval before comparison.

No contextualized exact-version metric has completed evidence review. Regulatory-document values, when available, are shown above with their limitations.

Koios DS- Breast regulatory performance study summary

Reader Study · Adult

exact submission · Tested version: 3.6 · n=900 · Independence not established

K242130

ACR AI Central summarizes the regulatory study; consult the exact FDA materials before comparative use.

Economics and lifecycle

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 2026-09-08

No public price or quote for the exact K242130 configuration was established in this review.

Reimbursement and coding
Not established in reviewed sources
Reviewed sources checked Exact FDA submission Checked 2026-09-08

No exact-product payer policy, coding instruction, or payment determination was established; eligibility must be evaluated by payer, site of service, and use case.

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
The exact-identifier FDA recall query returned no native recall record for K242130. This limited result does not establish absence of recalls or other safety information and does not cover later versions, family records, MAUDE reports, corrections, or field notices.
Public source Exact FDA submission Checked 2026-09-08

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
2026-09-08Last searched
25Fields reviewed
9Source classes checked
14Unreviewed PubMed leads
0Unreviewed trial leads
0Unreviewed FDA recall leads

Exact-submission ACR model-card fields were normalized under the current provenance rules; vendor and independent-study confirmation remain distinct. Exact FDA scope controls clinical claims. ACR and official vendor material provide bounded catalog or product-family context. Candidate literature metadata remains a discovery queue until full-text identity, endpoint, population, and version review is completed. Automated exact-name discovery found 14 PubMed and 0 ClinicalTrials.gov candidate records. Candidates require human product and version matching; zero candidates is not evidence that no studies exist. Native FDA recall identifiers produced 0 postmarket candidate records; 0 have been reviewed (0 published, 0 rejected) and 0 remain unreviewed.

Candidate leads remain unpublished until a human confirms the exact product and tested version.

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

Sources

Source ledger

Sources accessed through 2026-09-08.

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