Lung cancer is the most common cause of cancer death worldwide. More than 1.3 million people die annually and the 5-year survival rates have improved only marginally over the last three decades. While screening programs based on low-dose computed tomography (CT) have shown to reduce the number of deaths due to lung cancer, they raise a significant challenge, how to safely and accurately determine which small nodules (spots) found on a screening CT may be cancer. The aim of this project is to validate a new imaging technique to non-invasively reach the nodules and select of the best site in the lung to take tissue sample for pathology diagnosis. Preliminary results have shown that our new method, based on optical coherence tomography (OCT) and autofluorescence imaging (AF) instead of ultrasound, can more correctly identify the best site in the lung to biopsy and reach more of these nodules. The principle of OCT is similar to that of ultrasound but generates a higher resolution (sharper) image. Instead of sound waves, near-infrared light is used to produce a high definition image similar to looking down a microscope. Our OCT probe is much smaller than an ultrasound probe. It can detect blood vessels using the Doppler Effect and can analyze the chemical contents of the nodule using tissue autofluorescence and polarization imaging. The procedure is done under local anesthesia to the throat and conscious sedation. This innovative instrument will be the first of its kind to allow the accurate biopsy of small lung nodules while minimizing complications such as bleeding and lung collapse. It will advance the bronchoscopic diagnosis of small lung lesions and could become a key tool in the reduction of lung cancer mortality as part of a population based lung cancer screening program.