Ludwig DR, et al. - Through a single-center retrospective study that recognized individuals with a T1-hyperintense renal mass less than 4 cm on MRI, experts examined whether apparent diffusion coefficient (ADC) measurements could differentiate malignancy. The final cohort comprised 58 benign and 37 malignant renal lesions in 95 individuals. The interrater agreement for ADC measurements was nearly excellent. In malignant compared with benign lesions, ADC_ratio was significantly lower. Malignant lesions were significantly larger vs benign lesions, nevertheless, following controlling for lesion size, ADC_ratio continued to be an important predictor of malignancy. Hence, for T1-hyperintense small renal masses, ADC_ratio was highly reproducible and was significantly lower in malignant vs benign renal masses.