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Six radiomics features were selected from LASSO analysis. The average values of the area under the curve (AUC), accuracy, sensitivity, and specificity of radiomics analysis for predicting CLNM from F-FDG PET images were 0.79, 0.68, 0.65, and 0.70, respectively. In contrast, those of the CFM were 0.54, 0.60, 0.60, and 0.60, respectively. The F-FDG PET-based model showed significantly higher AUC than that of the CFM. The F-FDG PET-based model has better potential for diagnosing CLNM and predicting late CLNM in patients with tongue SCC than