Personalized Treatment of Head and Neck Cancers: Role of Functional Imaging and AI

Chemoradiotherapy plays an important role in the management of locally advanced head and neck squamous cell carcinoma. Unfortunately, a substantial fraction of patients experience treatment failure, while others suffer from significant treatment-related toxicity caused by intensive chemoradiotherapy regimens. This underscores the need for new biomarkers that can accurately capture the biological tumor heterogeneity and guide personalized therapy. Functional imaging combined with AI-based approaches such as radiomics and deep learning may offer a promising strategy for treatment stratification. However, a substantial number of challenges remain before clinical implementation can be achieved. Therefore, this review proposes a biology-driven framework for AI analysis of functional imaging in head and neck squamous cell carcinoma. In addition, it emphasizes the need for clinically oriented validation strategies to facilitate the translation of stratification models into clinical management.