Systems and methods for integrated real-time visualization while performing a minimally invasive procedure within anatomic passageways include a flexible catheter having one or more first lumens and a first positioning system, an imaging probe having one or more imaging elements, and a scaling device. In souse embodiments, the scaling device includes a plurality of second lumens and the flexible catheter and the imaging probe are each optionally deployed through a respective one of the second lumens. In some embodiments, the one or more imaging elements include one or more ultrasound transducers. In some embodiments, the scaling device seals the anatomic passageways at a scaling location using one or more balloons, and the anatomic passageways distal to the sealing location are collapsed. In some embodiments, the first positioning system includes one or more position sensors. In some embodiments, the procedure is performed after the passageways are collapsed.