EMR Versus ESD for Barrett's Neoplasia

Inclusion Criteria: * Patients age: ≥ 18 years * Willingness to undergo both EMR or ESD * Ability to provide written, informed consent (approved by IRB) and understand the responsibilities of trial participation * BE with at least one visible lesion ("target lesion") with absence of signs of submucosal invasion on endoscopy, after evaluation by the adjudication committee * Multiple lesions are allowed as long as the lesions are considered eligible for endoscopic treatment. Only the target lesion is evaluated for the study * Prior endoscopic resection is allowed Exclusion Criteria: * Patients with visible lesions with suspicion of submucosal invasion based on assessment of the adjudication committee * Patients with HGD in at least one random biopsy, before inclusion (i.e. during endoscopy in the referring center \<3 months before imaging, or during imaging endoscopy) * History of esophageal surgery other than fundoplication * History of esophageal ablation therapy * In case of prior endoscopic resection, the target lesion located within 1 cm of the prior resection site * Uncontrolled coagulopathy with INR \>2.0, thrombocytopenia with platelet counts \< 50,000 * Esophageal varix or varices * Subject has a known history of unresolved drug or alcohol dependency that would limit ability to comprehend or follow instructions related to informed consent, post-treatment instructions, or follow-up guidelines * Life expectancy \<2 years