Calculator: Thyroid Imaging Reporting and Data System (TI-RADS) with guidance on FNA of thyroid nodules in adults

Composition
		Spongiform, cystic, or almost completely cystic (0 points)
		Mixed solid and cystic (1 point)
		Solid or almost completely solid (2 points)
Echogenicity
		Anechoic (0 points)
		Hyperechoic or isoechoic (1 point)
		Hypoechoic (2 points)
		Very hypoechoic (3 points)
Shape
		Wider than tall (0 points)
		Taller than wide (3 points)
Margin
		Smooth or ill-defined (0 points)
		Lobulated or irregular (2 points)
		Extrathyroidal extension (3 points)
Echogenic Foci
		None or large comet-tail artifacts (0 points)
		Macrocalcifications (1 point)
		Peripheral (rim) calcifications (2 points)
		Punctate echogenic foci (3 points)

Important: Inputs must be complete to perform calculation.

Total criteria point count:

TI-RADS interpretation

Points	Category	Designation	Recommendation
0 to 1	TR1	Benign	No FNA
2	TR2	Not suspicious	No FNA
3	TR3	Mildly suspicious	FNA if lesion ≥2.5 cm or follow if lesion ≥1.5 cm
4 to 6	TR4	Moderately suspicious	FNA if lesion ≥1.5 cm or follow if lesion ≥1 cm
7 to 17	TR5	Highly suspicious	FNA if lesion ≥1 cm or follow if lesion ≥0.5 cm

Notes

Ultrasonographic classification applies directly to the population investigated and only indirectly, and imperfectly, to a specific patient.
FNA: fine-needle aspiration.

References

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; 14:587.
Grant EG, Tessler FN, Hoang JK, et al. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol 2015; 12:1272.

Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

Information on this page may not appear correctly if printed.

Legal Notices and Disclaimer

All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.

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