CBCT-Guided Navigational Bronchoscopy For Lung Nodules

Inclusion Criteria: * Participants ≥18 years old. * Participants with lesions having an intermediate pre-test probability of malignancy (pCA, 0.05 to 0.65) as determined by Swensen-Mayo nodule risk calculator and in whom bronchoscopic biopsy was determined to be the next best treatment step by the treating pulmonologist. * Participants with higher risk lesions (pCA \> 0.65) in need of a diagnosis for nonsurgical treatment or prior to surgery. * Participants are willing and able to provide informed consent. Exclusion Criteria: * The participant is pregnant as confirmed by urine or serum pregnancy testing. * There is a predetermined plan to pursue stereotactic body radiation therapy (SBRT) in the event of a nondiagnostic study procedure in participant's with a nodule in the outer 1/3 lung zone (i.e. The participant would not go on for a CT guided TTNA). * Lacked fitness according to physician judgement to undergo bronchoscopy. * Contraindication for temporary interruption of the use of anticoagulant therapy. * Uncontrolled or irreversible coagulopathy. * Known allergy for lidocaine. * Uncontrolled pulmonary hypertension. * Recent (\< 4 weeks) and/or uncontrolled cardiac disease. * Compromised upper airway (eg concomitant head and neck cancer or central airway stenosis such that endobronchial access is considered unsafe). * ASA classification ≥ 4. * COVID-19 positive participant at the time of procedure.