Gastrointestinal cancers are the sixth most common cancer and the third most common cause of cancer-related death in the world. Stomach malignancy diseases remain difficult to cure mainly because most patients are detected with the disease when it is already at an advanced stage. AI Medical Service Inc. (AIM) is a Japanese startup in the medical field with a mission to develop artificial intelligence-based systems that can help detect gastric cancers at an early stage.

The earlier the gastric cancers are detected, the higher the survival rate becomes. Medical research has found that about 4 – 25% of lesions get overlooked during endoscopy. This is because early gastric cancers are very difficult to detect, even for experts. Endoscopy exams are difficult and painful procedures and detecting tiny lesions in the inflamed gastric lining is challenging even for specialists with years of experience. The practice is also subject to human error as doctors in charge of double-checking images often have to read up to 3000 images per day in Japan.

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In order to aid early detection, founder and CEO of AI Medical Service Inc., Dr Tomohiro Tada — an expert endoscopist — started the company with a vision to develop an AI-based image recognition system that helps endoscopists improve their diagnosis. Starting with this goal of using deep learning technology to support endoscopists, AIM has developed and is ready to commercialise an Endoscopic AI solution that is reliable enough to detect and classify gastric cancers in real-time.

Leveraging deep learning tech to make real-time diagnosis a reality

The AI-driven software developed by the startup based in Tokyo leverages large scale training databases to analyse endoscopy images in order to support endoscopists in their diagnosis. The first product provides support for the endoscopist to aid them in stomach cancer detection, but with plans in the pipeline to cover other digestive organs including the oesophagus and intestines in the future. While the diagnosis is still made by doctors and not by the software, the technology has proven to be a trustworthy support partner, vastly improving the accuracy of clinical diagnosis.

Japan today leads the world in the advanced medical field of endoscopy owing to the use of AI image recognition technology which is contributing to the evolution of the field around the world. AI Medical Service Inc. has already applied for multiple global patents as the software has proven to deliver accuracy levels that are above the average endoscopy doctor. Not only do Japanese providers account for 70% of the world’s share of endoscopy equipment, but their specialised skills are recognised as the best in the world.

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Real-time assessments have become feasible owing to the improved hardware performance and the evolution of convolutional neural network models which form the basis of the artificial intelligence software. Making full use of deep learning image recognition technology, the company has developed an operational platform with its in-house “image anonymization processing software” and “image sorting WEB system” to maximise support for doctors’ diagnoses.

Owning to these breakthroughs, AI has advanced to the point where real-time detection of lesions during endoscopy is quite practical and set to become an indispensable tool in clinical departments around the world. Therefore, AIM is ready to embark on an ambitious expansion plan focusing on South East Asia.

Southeast Asia Expansion: AI technology to reduce non-detection of gastric cancers in the region

Since launching the company in 2017 the startup has grown to over 50 employees and is looking to expand in Southeast Asia in partnership with the Japan External Trade Organisation (JETRO). Masayuki Tokano, Manager for Overseas Affairs at AIM, is in charge of the SEA market business. Tokano remarked that even though their technology has potential for applications in other medical areas, AIM is dedicated to supporting endoscopists which was the original driver for their research: “We are committed to creating solutions that are truly useful in the clinical environment to save patients around the globe.”

Tokano is confident that their Endoscopic AI solution delivers accuracy equivalent to that of experts. “It is our mission to prevent gastric cancer from being overlooked, reduce the burden on endoscopists and provide cost-effectiveness to patients and hospitals with our Endoscopic AI,” he added.

Explaining their interest in exploring the Southeast Asian market Tokano says that the region is significant since gastric cancer is common not only in Japan but also in Southeast Asia. “The five-year survival rate declines significantly as the stage of the cancer advances. By supporting endoscopists in the SEA region with Endoscopic AI that is as accurate as experts, we can prevent gastric cancer from being overlooked and reduce the burden on endoscopists.” he explained.

Elaborating on the plans for the region, he said: “We are going to expand our solution, Endoscopic AI, in Singapore, Thailand and other regions with ageing populations similar to Japan with an aim to reduce the number of overlooked gastric cancers in the SEA region to ZERO.”

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The expansion to SEA will be a significant achievement for the startup as it considers setting up an R&D hub in Singapore that will serve as their regional hub to drive not only sales but also R&D. “Our goal is to establish product value through joint research with renowned medical institutions such as The National University Hospital of Singapore and Mahidol University in Thailand, and to develop our product in the SEA region,” remarked Tokano.

The use of AI in Medical Technology is a market valued at 11 trillion Japanese yen, however, currently there is no commercially available Endoscopic AI system for gastric cancer diagnosis. Tokano outlined their product development roadmap, saying: “By gaining PMDA approval next spring and HSA approval at about the same time, our product will be the world’s first AI product for gastric cancer. Our Endoscopic AI is vendor-agnostic, and the first product will have the function to classify gastric cancer. We are also developing AI products with the ability to detect gastric cancer, esophageal cancer, colon cancer and so on.”

By conducting joint research with top medical institutions in the SEA region, the company would like to develop the market in collaboration with distributors and related organisations in each country, remarked Tokano.

Support from Japanese government organisations gives their mission of overseas expansion a strong impetus. AI Medical Service Inc. has received support for R&D and overseas development from NEDO, JETRO, JICA, Tokyo Metropolitan Government and etc. “For the overseas development of Endoscopic AI, we are encouraged and certified as a J-Startup by the government,” he added.

Tokano feels that Endoscopic AI is a win-win product for all stakeholders including endoscopists, patients and hospitals. “By deploying our Endoscopic AI solution trained with over 200,000 videos collected from over 120 medical institutions in Japan and abroad to the SEA region, we would like to prevent gastric cancer from being overlooked, reduce the burden on endoscopists and contribute to the development of the SEA region,” he concluded.

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This article is produced by the e27 team, sponsored by JETRO

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