The critical need for an open medical imaging database in Japan: implications for global health and AI development.

Japan leads OECD countries in medical imaging technology deployment but lacks open, large-scale medical imaging databases crucial for AI development. While Japan maintains extensive repositories, access restrictions limit their research utility, contrasting with open databases like the US Cancer Imaging Archive and UK Biobank. The 2018 Next Generation Medical Infrastructure Act attempted to address this through new data-sharing frameworks, but implementation has been limited by strict privacy regulations and institutional resistance. This data gap risks compromising AI system performance for Japanese patients and limits global medical AI advancement. The solution lies not in developing individual AI models, but in democratizing access to well-curated Japanese medical imaging data. By implementing privacy-preserving techniques and streamlining regulatory processes, Japan could enhance domestic healthcare outcomes while contributing to more robust global AI models, ultimately reclaiming its position as a leader in medical innovation.