PTNB is a well-established technique for the diagnosis of lung cancer. In recent years, CT guidance has become the primary imaging modality, replacing fluoroscopy guided biopsies in many institutions. CT fluoroscopy, which is currently not universally available, offers promising advantages and may permit accurate and rapid procedures. A recent innovation in biopsy needles has been the introduction of automatic core biopsy needle devices that yield large specimens and improve the diagnostic accuracy of needle biopsy, particularly in benign lesions. PTNB is one of several methods available for tissue diagnosis of suspected lung cancer. The decision as to which method to use should be tailored to each patient, and is preferably reached by a team consisting of pulmonary physicians, chest surgeons, oncologists, cytologists, and radiologists.