Transbronchial vs Transthoracic Ablation for Early-stage Peripheral Lung Cancer

This study compares two minimally invasive methods to destroy small, early-stage lung cancers in patients who cannot or do not want surgery: bronchoscopy-guided ablation (going through the airway) versus CT-guided needle ablation (going through the chest wall). Researchers want to know which approach is safer and more effective. **You may be eligible if...** - You are 18 or older - You have been diagnosed with peripheral (outer) lung cancer, stage IA (T1N0M0), confirmed by biopsy - You are not a candidate for surgery, or you have declined surgery - Your tumor is accessible by both CT-guided and bronchoscopy-guided methods **You may NOT be eligible if...** - You have a very low platelet count or uncorrectable bleeding disorder - You have severe lung scarring (fibrosis) or high pulmonary blood pressure - You have an active infection near the tumor site or a high fever - You are pregnant Talk to your doctor to see if this trial is right for you.