In four centers , patients with suspected peripheral pulmonary lesions less than or equal to 30 mm in the longest diameter were included and randomized to undergo transbronchial biopsy with EBUS , fluoroscopy , and virtual bronchoscopic navigation guidance using a 3.0-mm ultrathin bronchoscope ( UTB group ) or a 4.0-mm thin bronchoscope with a guide sheath ( TB-GS group ) .