Draft:ACR TI-RADS
 | Review waiting, please be patient.
This may take 4 months or more, since drafts are reviewed in no specific order. There are 4,487 pending submissions waiting for review.
Where to get help
How to improve a draft
You can also browse Wikipedia:Featured articles and Wikipedia:Good articles to find examples of Wikipedia's best writing on topics similar to your proposed article. Improving your odds of a speedy review To improve your odds of a faster review, tag your draft with relevant WikiProject tags using the button below. This will let reviewers know a new draft has been submitted in their area of interest. For instance, if you wrote about a female astronomer, you would want to add the Biography, Astronomy, and Women scientists tags. Editor resources
Reviewer tools
|
ACR TI-RADS (Thyroid Imaging Reporting and Data System) is a standardized risk-stratification scoring system for thyroid nodules identified on ultrasound, developed by the American College of Radiology (ACR).[1]
Background
[edit]Thyroid nodules are extremely common, detected incidentally in up to 68% of patients undergoing neck ultrasound.[2] The vast majority are benign, and ACR TI-RADS was developed to reduce unnecessary fine-needle aspiration (FNA) biopsies while ensuring that malignant nodules are identified appropriately.
The system is modeled after BI-RADS (Breast Imaging Reporting and Data System), which similarly stratifies imaging findings into risk categories to guide management.
Scoring
[edit]ACR TI-RADS assigns points across five ultrasound feature categories:
| Category | Features scored |
|---|---|
| Composition | Cystic/spongiform (0 pts), mixed (1 pt), solid (2 pts) |
| Echogenicity | Anechoic/hyperechoic (1 pt), isoechoic (2 pts), hypoechoic (3 pts) |
| Shape | Wider-than-tall (0 pts), taller-than-wide (3 pts) |
| Margin | Smooth/ill-defined (0 pts), lobulated/irregular (2 pts), extrathyroidal extension (3 pts) |
| Echogenic foci | None/large comet-tail (0 pts), macrocalcifications (1 pt), peripheral calcifications (2 pts), punctate echogenic foci (3 pts) |
Points from all five categories are summed. Any number of findings in the echogenic foci category are added cumulatively.
Risk categories
[edit]| TR Level | Points | Malignancy risk | Management |
|---|---|---|---|
| TR1 | 0 | Benign | No FNA |
| TR2 | 2 | Not suspicious | No FNA |
| TR3 | 3 | Mildly suspicious | FNA if ≥ 2.5 cm; follow if ≥ 1.5 cm |
| TR4 | 4–6 | Moderately suspicious | FNA if ≥ 1.5 cm; follow if ≥ 1 cm |
| TR5 | ≥ 7 | Highly suspicious | FNA if ≥ 1 cm; follow if ≥ 0.5 cm |
Published malignancy rates range from less than 2% for TR1/TR2 nodules up to greater than 20% for TR5 nodules.[3]
Clinical use
[edit]ACR TI-RADS is widely adopted in North America and is recognized by the [[American Thyroid Association]] and other international societies. When multiple nodules are present, up to two nodules with the highest point totals are prioritized for biopsy, which may not necessarily be the largest nodules.
Several free online calculators have been developed to assist clinicians in applying the scoring criteria at the point of care.[4]
See also
[edit]References
[edit]- ^ 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
- ^ Grani G, Sponziello M, Pecce V, Ramundo V, Durante C. Contemporary Thyroid Nodule Evaluation and Management. J Clin Endocrinol Metab. 2020;105(9):2869–2883.
- ^ Tessler FN, et al. 2017.
- ^ "ACR TI-RADS Calculator". Retrieved 2026-06-09.
External links
[edit]- ACR TI-RADS Calculator – Free point-of-care scoring tool
- ACR TI-RADS official page
- Radiopaedia: ACR TI-RADS