Park SY, et al. - A comprehensive analysis of the CT criteria for achieving high positive predictive value (PPV) for renal cell carcinoma (RCC) in patients with solid small renal masses (SRMs) less than 4 cm without macroscopic fat was conducted. Interpretation of CT images allowed reproducible and excellent PPV for RCC. The current CT criteria could effectively shorten the management process for solid SRMs without macroscopic fat by reducing unnecessary biopsies for a significant number of RCCs demonstrating typical CT findings.