TIRADS Calculator

Evaluation of thyroid nodules on ultrasound using ACR's Thyroid Imaging Reporting & Data System (TI-RADS ™), with images from ACR's TIRADS atlas

TI-RADS new (report)
How is the nodule's composition?
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 is the nodule’s echogenicity? (Compared to the adjacent parenchyma)
How are the margins?
If there are any additional features, choose all that apply.
TR-1 (Benign)
No further follow-up is needed
<2% chance of malignancy
Note: Spongiform, cystic, and almost completely cystic nodules always have a TI-RADS score of 1, irrespective of their other features.
TR-5 (Highly suspicious)
FNA if ≥ 1cm - Follow-up imaging if ≥ 0.5cm (annually up to five years)
>20% chance of malignancy

TR-1 (Benign)
No further follow-up is needed
<2% chance of malignancy
TR-2 (Not suspicious)
No further follow-up is needed.
<2% chance of malignancy
TR-3 (Mildly suspicious)
FNA if ≥ 2.5cm - Follow-up imaging if ≥ 1.5cm (in 1, 3, and 5 years)
<5% chance of malignancy
TR-4 (Mildly suspicious)
FNA if ≥ 1.5cm - Follow-up imaging if ≥ 1cm (in 1, 2, 3, and 5 years)

5-20% chance of malignancy

Reference:

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More about the ACR TIRADS Calculator:

The Thyroid Imaging Reporting and Data System (TIRADS), developed by the American College of Radiology (ACR), is a standardized system for evaluating thyroid nodules based on ultrasound features. It provides a structured and objective approach to nodule assessment, ensuring consistency and clarity in diagnosis. While our interactive TIRADS calculator is not officially endorsed by the ACR, it is carefully designed to support clinical practice by aligning with the ACR's mission of standardizing imaging protocols and improving diagnostic accuracy.

The TIRADS system categorizes ultrasound findings into specific risk levels by assigning points to nodule characteristics, such as:

  • Composition: Solid, cystic, or mixed composition of the nodule.
  • Echogenicity: Hypoechoic, isoechoic, or hyperechoic appearance relative to surrounding thyroid tissue.
  • Shape: Taller-than-wide configuration, which may indicate higher malignancy risk.
  • Margins: Smooth, irregular, or extrathyroidal extension.
  • Echogenic Foci: Presence of microcalcifications, macrocalcifications, or peripheral calcifications.

These features are scored, and the total determines the TIRADS category, which ranges from TR1 (benign) to TR5 (high suspicion). This categorization guides subsequent management recommendations, including the need for biopsy, follow-up imaging, or reassurance.

Streamlining Clinical Workflows

Our interactive calculator simplifies the TIRADS scoring process, automating the classification based on user input. By doing so, it reduces manual effort, minimizes errors, and allows healthcare providers to focus on patient care. The calculator is designed to be intuitive and user-friendly, making it a practical tool for radiologists, endocrinologists, and other clinicians involved in thyroid nodule assessment.

Promoting Consistency and Confidence

The adoption of the TIRADS framework enhances diagnostic consistency by providing a common language for reporting thyroid nodules. It improves communication between radiologists and referring physicians, ensuring that all stakeholders have a clear understanding of the risk profile associated with each nodule. This structured approach not only streamlines clinical workflows but also fosters confidence in decision-making, particularly when determining whether to proceed with invasive procedures or monitoring.

Reducing Unnecessary Procedures

One of the key advantages of TIRADS is its ability to stratify risk, helping to avoid unnecessary biopsies or surgeries for benign nodules while prioritizing intervention for high-risk cases. By incorporating evidence-based criteria into clinical practice, the calculator supports personalized, precise patient care that balances caution with efficiency.

Evidence-Based Design

Although this calculator is not officially affiliated with or endorsed by the ACR, it leverages the robust evidence underpinning the TIRADS system. The scoring methodology aligns with the ACR's descriptors, ensuring that users can apply the calculator confidently in clinical scenarios. Furthermore, its design emphasizes the practical application of TIRADS principles, making it suitable for use in diverse healthcare settings, from private practices to academic institutions.

Empowering Clinicians and Patients

By automating the scoring process and providing clear risk stratifications, the calculator empowers clinicians to make informed decisions with greater efficiency. This tool not only enhances diagnostic precision but also improves patient communication by providing a clear and systematic explanation of nodule findings and their implications.

Optimizing Outcomes

Integrating the ACR TIRADS calculator into clinical practice can significantly improve the accuracy of thyroid nodule assessments, leading to better patient outcomes. The combination of standardized descriptors, automated calculations, and user-friendly design ensures that healthcare providers can deliver high-quality, evidence-based care with ease.

In conclusion, the ACR TIRADS calculator represents a valuable resource for implementing a standardized approach to thyroid nodule evaluation. Whether in radiology departments, outpatient clinics, or teaching environments, this tool supports accurate risk assessment and informed decision-making, ultimately benefiting both clinicians and patients. For more information on the methodologies and research behind the TIRADS system, refer to the resources listed above.

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