Our work with Dr. Hesham Elhalawani (Dept. of Radiation Oncology, M.D Anderson Cancer Center) on early prediction of Osteo-radio-necrosis (ORN) using radiomics has been accepted to the American Society for Radiation Oncology’s Head and Neck cancer (ASTRO-HNC) symposium in 2018. We show that a functional principal component analysis (FPCA) of radiomic features extracted at multiple time points before and after radiotherapy, can predict for ORN development in patients. We significantly outperform prediction models based on pre-radiotherapy images and delta radiomics (current practice). We envisage our FPCA screening tool can be used by radiologists to optimize radiation plan for patients undergoing radiotherapy!