Inclusion Criteria:  Histologically confirmed, locally advanced HNSCC, HPV negative considered as intermediate or high risk . Offered radical treatment. (This includes surgery and any postoperative adjuvant/consolidation treatment, or radical chemo-radiation). Age ≥ 18 years. Adequate bone marrow function (nNeutrophils, platelets and haemoglobin grade 0 or 1 according to CTCAE).  Exclusion Criteria:  HPV positive disease. Participants with concurrent malignancy. Confirmed distant metastatic disease on most recent imaging scan. Known Hepatitis B, C or HIV infection . Contraindications to MRI (including but not limited to cardiac pacemaker, metallic implants, major claustrophobia). Pregnant and lactating patients.