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The opportunity now exists to make penumbral imaging even more portable, affordable, and more widely available using mobile platforms, novel imaging techniques, digital linkage, and artificial intelligence. Endoscopic submucosal dissection (ESD) is a widely accepted and minimally invasive treatment for early gastric cancer (EGC) without the risk of lymph node metastasis (LNM). However, undifferentiated-type EGC (UD-EGC) is considered to have a relatively high risk of LNM. Recently, the Japan Clinical Oncology Group conducted a nonrandomi