International Medical News

No.524ISSN 0535-1405

INTERNATIONAL MEDICAL NEWSInternational Medical Society of Japan
Since 1925
July 31, 2024

The 464th International Symposium on Therapy
Industry-academia collaboration in the GI endoscopy.
The progress and challenge in Japan■Introductory Message from the Chair
K. Sumiyama, MD, PhD. Managing Director, IMSJ

■LectureⅠ
Frontlines of Medical AI: Challenges of a University-Originated Startup
Yuki Shimahara, PhD
Founder, LPIXEL Inc.

■LectureⅡ
Development of Flexible Endoscopic Devices: The Surgeon’s Perspective
Kiyokazu Nakajima, MD, PhD
Professor,Department of Next Generation Endoscopic Intervention,
Osaka University Graduate School of Medicine

Published by International Medical Society of Japan,Chairman, Board of Directors: Kenichi Ishibashi, MD, PhD,Editors: K. Ito, MD, PhD, T. Kondo, MD, K. Ichihashi, MD, PhD, T. Murakami, PhD,
R. Nagai, MD, PhD, T. Sumiyama, MD, PhD, I. Taniguchi, MD, PhD, and T. Yamazaki, MD,PhD.
1-11-9-3F Kamiuma, Setagaya-ku, Tokyo154-0011, Japan.
TEL 03(5486)0601 FAX 03(5486)0599 E-mail: imsj@imsj.or.jp https://www.imsj.or.jp/

International Medical News

Industry-academia collaboration inthe GI endoscopy.
The progress and challenge inJapanThe 464th International Symposium on Therapy was held by the Zoom Webinar onMay 23, 2024. Dr. Kazuki Sumiyama, Director of the International Medical Society ofJapan (IMSJ), presided over the meeting.
Kazuki Sumiyama, MD, PhD
Director, IMSJ

LectureⅠ
Frontlines of Medical AI: Challenges of a University-OriginatedStartupYuki Shimahara, PhD
Founder, LPIXEL Inc.
The rapid development of AI technology since 2010s has expanded beyond theframework of traditional computer science and is paving the way to contribute widely tohuman culture and welfare. Naturally, the medical field has also attracted significant
interest and has been influenced by AI. In the past decade, research and development
for AI in the medical field has progressed. Especially since 2020, many AI have been
approved as programmed medical devices, establishing AI as more than just a temporary
trend and has now been used in real clinical situations. This presentation introduces themacro trends of politics and administration surrounding medical AI, and from a micro
perspective, introduces the image diagnostic AI, EIRL, developed by the universityoriginated startup LPIXEL Inc., to provide a comprehensive understanding of the industry.
2

International Medical News

[1] Lung Nodule Detection AI "EIRL Chest Nodule"This product detects nodules from chest X-rays and displays a rectangle around thelesion area (5 mm ~ 30 mm). After testing with 18 doctors, it was confirmed that the useof this product improved the reading sensitivity from 45.4% to 57.0%, maintaining its highspecificity (Radiologists: 47.1% to 57.1%, Non-specialists: 43.8% to 56.9%).
[2] EIRL Colon Polyp*
This product assists in detecting colon polyp candidates from images obtained duringcolonoscopies, displaying an alert frame followed by a box around the four corners of
the candidate area.
▼Performance Evaluation Results
In a retrospective performance evaluation test using positive videos (59) and negativevideos (136) extracted from colonoscopy videos on Olympus Medical Systems
endoscopy system, the results were as follows:
Sensitivity (based on lesion)
・Estimated value: 98.1%
・95% CI: 94.6%- 99.6%
Specificity (frame-based)
・Estimated value: 95.0%
・95%CI: 94.6%- 95.3%
Initially, only products from Olympus Medical Systems were targeted, but after a version
upgrade, Fujifilm’s endoscopy system was also included.
3The products described above have undergone version upgrades following their market
introduction, with some products utilizing the IDATEN system**. Quickly incorporating
abundant feedback into product development and continuously upgrading is one of ourcompany's strengths. In this presentation, we will introduce feedback from the field anddiscuss future expectations and challenges.
*This software was developed into a product based on the results of collaborative
research conducted by The Jikei University School of Medicine and LPIXEL Inc., with thesupport of the AMED.
**The IDATEN system refers to a review system that allows improvements within the scopeof the plan after obtaining approval for medical devices such as software medicaldevices utilizing AI, which are expected to have performance improvements after
obtaining manufacturing and sales approval. PMDA pre-approves possible changes

International Medical News

related to performance improvements (software version upgrade plans, etc.).

LectureⅡ
Development of Flexible Endoscopic Devices:
The Surgeon’s Perspective
Kiyokazu Nakajima, MD, PhD
Professor,
Department of Next Generation Endoscopic Intervention,
Osaka University Graduate School of Medicine
For us surgeons, flexible endoscopy, or just “endoscopy” is near and far. Although
we have opportunities to use them in our daily practice, we do not often performsurgery with them. Surprisingly, it is “endoscopists” who are able to dexterously performsurgeries with this long and floppy device. They are specialists in internal medicine,
not surgery. I find this quite interesting, first of all.
We surgeons use laparoscope. It is rigid, and much shorter than endoscope. They
may look similar, but they are completely different devices. Again, I find it interestingthat the endoscope used by internists can perform a variety of surgeries, while thelaparoscope used by surgeons is itself a just scope that can perform almost no surgery.
The endoscope used by endoscopist is inserted into the digestive tract (lumen)
through the mouth or anus (natural orifice), without penetrating the body surface.
Laparoscopes, handled by surgeons, on the other hand, are inserted into theabdominal cavity after making a hole on the body surface. Thus, endoscopy andlaparoscopy have been simply divided into medical or surgical, without scalpel orwith scalpel, lumenal or abdominal. However, the boundary between the two has
recently become a little blurred: endoscope enters the abdominal cavity (NOTES:Natural Orifice Translumenal Endoscopic Surgery), endoscope and laparoscope
operate together (LECS: Laparoscopy Endoscopic Cooperative Surgery), and more!
This is the area where “confusion” arises, but also where “innovation” can occur.
Confusion seems to be caused by stereotypes such as “endoscopy is like this” or“laparoscopy is like that.” The stereotypes extend to the way the devices are used,
how they are used, and even the way the users (medical doctors) think. In other words,
the structural differences between endoscopes and laparoscopes, and theInternational Medical News

differences between flexible instruments and surgical instruments, would induce
differences in technique, and ultimately conflict between medicine and surgery.
On the other hand, innovation is produced by thinking with a flexible mind, free fromstereotypes, such as “interpreting endoscopy from a surgeon’s point of view” or“looking at laparoscopy from an endoscopist's point of view.” In fact, endoscopes
are full of mysteries to surgeons. In this talk, I will start with what surgeons feel “strange”
or “why?” about endoscopy. This presentation will introduce our efforts to create
innovations through the collaboration between endoscopists and surgeons, andindustry and academia. I hope this presentation will be of interest to those who areinterested in creating innovation in the field of endoscopy.

発 行 人

石橋 健一

編集委員

伊 藤 公 一、近 藤 太 郎、市 橋光、村 上 貴 久

永 井 良 三、炭 山 和 毅、谷 口 郁 夫、山 崎
編集事務早 川 裕 子、西 山 敏 夫

発 行 所

公益財団法人日本国際医学協会

力〒154-0011 東京都世田谷区上馬 1-11-9-3F
TEL03(5486)0601

FAX03(5486)0599

E-mail: imsj@imsj.or.jp
発 行 日2024 年 7 月 31 日

URL: https://www.imsj.or.jp/