TI-RADS ™ Calculator

Evaluation of thyroid nodules on ultrasound using ACR's Thyroid Imaging Reporting & Data System (TI-RADS)

TI-RADS
How is the nodule's composition?
How is the nodule’s echogenicity? (Compared to the adjacent parenchyma)
How is the nodule's shape?
Note: Nodule's shape should be assessed on a transverse image with measurements parallel to the sound beam for height and perpendicular to the sound beam for width.
How are the margins?
Are there any additional features? Choose all that apply.

→ No further follow-up is needed.
Note: Spongiform, cystic, and almost completely cystic nodules always have a TI-RADS score of 1, irrespective of their other features.
→ No further follow-up is needed.
→ FNA if ≥ 2.5cm
→ Follow-up imaging if ≥ 1.5cm (in 1, 3, and 5 years)
→ FNA if ≥ 1.5cm
→ Follow-up imaging if ≥ 1cm (in 1, 2, 3, and 5 years)
→ FNA if ≥ 1cm
→ Follow-up imaging if ≥ 0.5cm (annually up to five years)

Chance of malignancy per TI-RADS:

  • TR-1: Benign (<2% chance of malignancy)
  • TR-2: Not suspicious(<2% chance of malignancy)
  • TR-3: Mildly suspicious(<5% chance of malignancy)
  • TR-4: Moderately suspicious(5-20% chance of malignancy)
  • TR-5: Highly suspicious(>20% chance of malignancy)

All images on this page are obtained from ACR's TI-RADS atlas.

Click here to download the full document for TI-RADS from ACR's website.

Reference:
  1. Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017;14(5):587-595. doi:10.1016/j.jacr.2017.01.046

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