The definitive guide on H&N nodal contouring is this: Gregoire et al. Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiotherapy and Oncology. 2014; 110: 172-181 When I was learning H&N contouring I found the paper very hard to get my head around. We can simplify things and I’ve done this to act as a crib sheet. But do go back to Gregoire for the details. Level IA: submental: In the midline between the anterior belly of the digastric muscles. Level IB: submandibular: Lateral to the digastric muscle... go all the way back to include the submandibular gland. Levels II/III/IV: deep cervical: Under (deep to) the sternocleidomastoid, running from C1 to manubrium. Medial limit is the common carotid. Cranio-caudally divided into 3 sections by the hyoid and cricoid (inferior aspects). VA/B/C: posterior triangle: Between the sternocleidomastoid and trapezius. Cranio-caudally divided into 3 sections by the cricoid (inferior aspect) and the cervical transverse vessels. Technically goes up as far as the hyoid, but sometimes we contour as far up as the space exists (technically occipital nodes). Stop 2cm above the manubrium. VI: anterior compartment: In the midline between sternocleidomastoids, from level I to manubrium. The nodal staging is the same for most types of H&N ca, but the two exceptions are nasopharyngeal (because the nodal drainage is quite different) and HPV-related oropharyngeal (because it’s common to get lots of big nodes but the prognosis is still good).