Lung cancer is a disease where the majority of diagnosis are made on small fine needle aspirate (FNA) samples due to risk of a pneumothorax (punctured lung). A fluid biopsy is safer and easier to accomplish with a lower amount of patient risk. It is also faster to execute and schedule. Most fluid biopsy technology in the year 2019 focuses on nucleic acid detection and does not include whole cancer cells whose morphology is capable of confirming the diagnosis of cancer and the tissue of origin of the cancer. Past attempts at using circulating tumor cells as the diagnostic material were insufficient, because there was no way to determine the tissue of origin of the circulating cells. Advances in imaging mass cytometry (IMC) now make it possible to combine nucleic acid based characterization of circulating cells together with protein characterization of the cells to provide a comprehensive fluid biopsy. The Kuhn-Hicks lab at USC is particularly suited to advance this technology and has a track record of success in translating fundamental biomarker technology into commercially viable diagnostic tests. This proposal will seek to validate a diagnostically complete circulating tumor cell assay that incorporates the necessary protein, nucleic acid, and cytological elements needed for a true diagnostic fluid biopsy.