In early 2024, the World Health Organization predicted that by 2050, there would be more than 35 million new cases of cancer worldwide, up 77% from the 20 million in 2022. Due to aging and the development of populations, as well as lifestyle factors. , the burden of cancer will have a major impact on countries around the world. In Japan, doctors and engineers are harnessing synthetic intelligence (AI) and other technologies to meet a huge demand for equipment to diagnose and treat cancer and similar diseases. Two cutting-edge medical startups from Tokyo are commercializing their inventions to improve the fitness of others around the world.
Early and correct diagnosis is essential in the fight against diseases such as cancer. However, a recent study found that in the United States, about 800,000 people die or are permanently disabled each year due to misdiagnoses and untreated cancers. Gastrointestinal (GI) cancers are the leading cause of cancer mortality in Japan and worldwide, mainly because they are detected too late. Although an endoscopic examination can detect gastrointestinal cancer, about 20% of cancers at an early stage go unnoticed by doctors when they examine the upper gastrointestinal tract of patients.
But what if AI could double-check gastroscopy images and pick up any missed problem spots? That’s exactly what AI Medical Service Inc.’s gastroAI model-G does. It’s an AI system that views gastroscopy imagery in real time along with doctors, and makes suggestions about examining potential areas of concern. As an endoscopist feeds a gastroscope into a patient’s stomach and performs the usual procedure, gastroAI instantaneously reviews the imagery. If it detects a problem spot, within seconds the software highlights the area and displays a warning notice: “Consider biopsy.” The endoscopist makes the diagnosis and is free to consider the need for a biopsy and make a diagnosis based on the system’s suggestions.
“The endoscopic examination is necessarily a process of symbolic popularity,” explains Tada Tomohiro, CEO of AI Medical Service. “Doctors read about the abdomen or colon and see if there is an injury or not. The formula acts as an assistant, asking the doctor to double-check for potential problem areas. Even if the accuracy of doctors decreases from morning to afternoon, the AI formula does not get tired.
After working in Tokyo hospitals, Tada opened a gastroenterology and proctology clinic in Saitama Prefecture in 2006, where he and other staff performed 8,000 to 9,000 endoscopic examinations a year, making it one of the centers of medical most productive gastrointestinal tract in the country. Array Even as he opened more clinics, Tada began looking for new tactics to reduce missed diagnoses. He learned that AI could surpass human functions in symbol recognition, a very important detail in the detection of gastrointestinal cancers.
gastroAI model-G makes instant recommendations such as “Consider a biopsy” for imaginable lesions.
In 2016, he began applying AI equipment to endoscopic medicine. He trained a deep-learning AI formula, collected about 200,000 high-definition videos on gastrointestinal medicine, and developed what he describes as the world’s first AI formula for the early detection of gastric and esophageal cancer. cancer. In 2017, Tada founded AI Medical Service and later established subsidiaries in the United States and Singapore. One of the company’s benefits is a strong research network that provides it with insights from more than a hundred medical centers in Japan, in addition to Tokyo University Hospital, Keio University Hospital, and Osaka International Cancer Institute. Another asset lies in its links with manufacturers. AI Medical Service has focused on creating software that can be used with as many endoscopes as possible. .
“Japan is a top producer of endoscopes,” Tada notes. “Working with manufacturers is part of a strategy to make Japan No. 1 in the world for medical technology.”
AI Medical Service’s diagnostic support system has been approved by regulators in Japan, Brazil, and Singapore, and the company has raised some 14.5 billion yen (US$93.4 million) in funding from venture capital firms and government subsidies. In 2024, AI Medical Service was included in Forbes Asia’s 100 to Watch list of small companies and startups grabbing investors’ attention. Tada is now focused on rolling out his product in Singapore, updating the system along with the evolution of AI, getting approval from U.S. regulators and targeting other forms of cancer for AI detection, even as he continues his clinical work.
“Whether I work as a doctor, clinic director, or CEO of a startup, my approach doesn’t change,” says Tada. “My motivation is medical practice. Ultimately, we must reduce the rate of missed cancer detections to zero.
Across town, at Tokyo Medical University Hospital, a cancer patient lies down while a cone-shaped device on a robotic arm is placed over his abdomen. The device sends ultrasound energy to the patient’s pancreas and generates localized heat of up to one hundred degrees Celsius that destroys cancer cells in the organ. Other types of ultrasound waves allow doctors to monitor the precise location of the heated region. The procedure is minimally invasive, requires no surgery or anesthesia, and only takes about half an hour.
This strategy uses maximum intensity targeted ultrasound (HIFU). In traditional radiation therapy, radiation damages cancer cells and the surrounding healthy cells that it passes through. In contrast, HIFU waves can focus on a small region of the body and not damage the healthy cells they pass through. Although focal power decreases with intensity under the skin, it can be used in cases where cancers recur frequently.
“With high-intensity targeted ultrasound, patients can be treated with just two outpatient sessions,” explains Satoh Tohru, CEO of Sonire Therapeutics Inc.
In studies around the world, targeted ultrasound has been used to target cancers of the brain, breast, prostate, and other organs. In Japan, HIFU is already used to treat enlarged prostate, Parkinson’s disease, and essential tremor. Japanese doctors now hope that HIFU will become a popular remedy for pancreatic cancer, one of the deadliest and most recurring cancers. Additionally, approximately 70% of pancreatic cancer cases are detected after the disease has progressed too far to be removed surgically, resulting in a three-year survival rate of only 3. 2%. Even after surgery, the cancer returns in about 80% of patients.
Pancreatic cancer is difficult to treat in part because the organ moves up and down while a patient is breathing, causing therapeutic radiation to impact the surrounding gastrointestinal tract.
“The pancreas is resistant to radiation, so it requires high doses of radiation therapy, which can involve daily sessions for six weeks,” says Satoh Tohru, chief executive of SONIRE Therapeutics Inc. , a Tokyo start-up of next-generation next-generation HIFU for cancer remedy. “With SONIRE HIFU, patients deserve to be treated in just two outpatient sessions. »
The unique part about SONIRE’s technology is that it makes use of cavitation. Often seen around underwater propellers, cavitation is the formation of gas bubbles in a liquid due to pressure changes. Using cavitation allows doctors to precisely visualize the treatment region to ensure effective treatment and increase heating efficiency, which shortens treatment time.
Results suggest HIFU can be effective when used with conventional treatment. The median survival time of patients with inoperable pancreatic cancer after treatment with chemotherapy alone was 288 days, but when combined with HIFU it was 648 days, according to a 2021 study in the journal Current Oncology.
Satoh co-founded SONIRE in 2020, building on studies that began about 12 years earlier at Tokyo Medical University, Tokyo Women’s Medical University, and Tohoku University. With the help of Japanese venture capital firms, SONIRE temporarily raised 730 million yen ($4. 7 million) in funding. This has allowed it to expand its own HIFU treatment formula as next generation targeted ultrasound.
Sonire’s next-generation HIFU treatment formula can target pancreatic cancer cells with high-intensity, non-invasive ultrasound.
SONIRE’s innovation has earned it national and foreign recognition. In 2023, he was chosen for the J-Startup program of the Ministry of Economy, Trade and Industry. The following year, its HIFU treatment formulation was designated as a breakthrough pancreas device. cancer through the US Food and Drug Administration. These distinctions have opened doors.
With its research and clinical partners, SONIRE is now conducting the world’s first randomized, controlled trial of HIFU therapy for pancreatic cancer. The study at six hospitals across Japan is designed to give hope to patients, their families and healthcare professionals, and will follow the survival outcomes of 90 patients with inoperable pancreatic cancer, with 30 undergoing chemotherapy alone and 60 undergoing chemotherapy and HIFU therapy.
SONIRE aims to complete enrollment in early 2025 and obtain regulatory approval for HIFU therapy in Japan in 2027. Meanwhile, a U.S. study is also being prepared, with the aim of obtaining U.S. approval in 2028. From there, the company hopes to expand not only into other markets, but other types of cancer.
“We need to offer more effective and safer cancer treatments to as many patients as possible and in the shortest possible time,” says Satoh. “We need to overcome the barriers between prescription drugs and medical devices, and one way to do that is by using the HIFU remedy for cancer patients. »
Note: All Japanese calls in this article are given in the classic Japanese order, with the circle of relatives calling first.
To learn more about AI Medical Service Inc., click here.
To learn more about SONIRE Therapeutics Inc. , click here.