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We report risks and patterns of nodal disease based on primary site and nodal level from data on the dissected cN0 per the results from ACRIN 6685.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective nonrandomized enrollment included participants with first\u2010time head and neck squamous cell carcinoma and at least 1 cN0\u00a0neck side to be dissected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Twenty\u2010four ACRIN\u2010certified centers internationally (American College of Radiology Imaging Network).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 287 participants were enrolled. Preoperative FDG\u2010PET\/CT findings were centrally reviewed and compared with pathology. Incidence, relative risk, pattern of lymph node involvement, and impact upon neck dissection were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An overall 983\u00a0nodal levels were dissected (n = 261\u00a0necks, n = 203 participants). The highest percentages of ipsilateral positive nodes by primary location and nodal level were oral cavity (level I, 17\/110, 15.5%), pharynx (level II, 6\/30, 20.0%), and larynx (level VI, 1\/3, 33.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Levels at greatest risk for nodal disease in cN0\u00a0in terms of ipsilateral neck dissection are level I (oral cavity), II (pharynx), and VI (larynx). These data should be considered when treating patients presenting with cN0. This is the first study to comprehensively report the incidence, location, and risk of metastases in cN0\u00a0in the FDG\u2010PET\/CT era.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820969104","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T16:30:27Z","timestamp":1606235427000},"page":"1230-1239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["FDG\u2010PET\/CT and Pathology in Newly Diagnosed Head and Neck Cancer: ACRIN 6685 Trial, FDG\u2010PET\/CT cN0"],"prefix":"10.1002","volume":"164","author":[{"suffix":"Jr","given":"Brendan C.","family":"Stack","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Southern Illinois University Springfield Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenghai","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Center for Statistical Sciences School of Public Health Brown University Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rathan M.","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine Department of Radiology and Harold C. 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