Functional imaging of the kidney using radiological techniques has a great potential of development because the functional parameters, which can be approached non-invasively, are multiple. CT can provide measurement of perfusion and glomerular filtration but has the inconvenient to deliver irradiation and potentially nephrotoxicity due to iodine agents in this context. Sonography is able to evaluate perfusion only but quantification remains problematic. Therefore, MR imaging shows the greatest flexibility measuring blood volume and perfusion as well as split renal function. The main applications of perfusion imaging of the kidney are vascular diseases, as renal artery stenosis, renal obstruction and follow-up of renal tumors under antiangiogenic therapy. However, full clinical validation of these methods and the evaluation of their clinical impact are still often worthwhile.

Thermal ablation techniques for renal tumours have become the norm in surgically at-risk patients. These percutaneous treatments are locally effective, particularly for tumours measuring less than 4cm. Larger tumours may be treated by adapting the technique and strategy. Multidisciplinary discussion is essential before any decision, in order to decide on the most appropriate technique. Radiofrequency is simple, effective and inexpensive. Cryotherapy is more complex and should be preferred when the tumour is large or there is vascular or urinary tract contact. Microwaves can be used to treat larger tumours. Morbidity is low, but good knowledge of these techniques and of dissection is required to avoid injury to neighbouring digestive or urinary structures.

The quantification of the ADC of the neck of the femur is reproducible. This could be useful in the treatment of LCPD, where there is an early and significant increase in the ADC on the pathological side. This increase could have a prognostic value, as it is correlated with the Catterall classification.