Methods, systems, and devices for accessing tissue outside a bronchus and marking the location of a biopsy are provided. The method includes loading a navigation plan into a navigation system with the navigation plan including a CT volume generated from a plurality of CT images, inserting an extended working channel (EWC) including a location sensor into a patient's airways, registering a sensed location of the EWC with the CT volume of the navigation plan, and selecting a target in the navigation plan located outside the periphery of a patient's airways. The method further includes navigating the EWC and location sensor proximate the target, inserting a piercing catheter into the EWC, piercing through an airway wall to reach the target, storing a position of the location sensor in the navigation system as a biopsy location, and performing a biopsy at the stored biopsy location.
