(UroToday.com) Incidental discovery of renal masses has increased with more utilization of cross-sectional imaging, leading to more partial and radical nephrectomies. However, contrast-enhanced imaging is unreliable in differentiating between benign oncocytoma and malignancy kidney masses. The Aorta-Lesion-Attenuation-Difference (ALAD) and Peak Early-phase Enhancement Ratio (PEER) are two imaging-based calculations that may be used to differentiate oncocytoma versus malignancy.1 At the Southeastern Section of the AUA 2021 Virtual Meeting, Dr. Steven Lomax and colleagues presented results of their study evaluating the efficacy of the ALAD and PEER on contrast-enhanced computed tomography (CT) to differentiate between the appearances of chromophobe renal cell carcinoma and oncocytoma.