Diagnostic tests in urology: percutaneous biopsy of renal masses

What's known on the subject? and What does the study add? Small renal masses are often detected incidentally with abdominal CT. About 80% of these masses are malignant. Many studies have investigated the diagnostic accuracy of small renal mass biopsy using various techniques. This has resulted in a broad range of published sensitivities and specificities without a clear guide for clinical use. This evidence‐based medicine article addresses the clinical utility of renal mass biopsy. Based on a common patient scenario, a guide to calculating the probability of malignancy after a benign biopsy is provided. The scenario is used to show the potential influence of renal mass biopsy on clinical decision‐making. This appraisal also discusses the limitations of the current literature, highlighting the need for multi‐institutional studies with standardised biopsy techniques and a reliable comparator to confirm the clinical utility of this diagnostic test.