TI-RADS

thyroid imaging reporting and data system (TI-RADS)

• places thyroid nodule in five levels (TR1 to TR5) based on five ultrasound features: composition, echogenicity, shape, margin, and punctate echogenic foci

• each feature is assigned points; thus, the more points a nodule is assigned, the higher the risk for malignancy

TR1

• 0 points

• benign

• no FNA

• cancer risk: 0.3%

TR2

• 2 points

• not suspicious

• no FNA

• cancer risk: 1.5%

TR3

• 3 points

• mildly suspicious

• ≥ 1.5 cm: follow-up at 1, 3, and 5 years

• ≥ 2.5 cm: FNA

• cancer risk: 4.8%

TR4

• 4-6 points

• moderately suspicious

• ≥ 1.0 cm: follow-up at 1, 2, 3, and 5 years

• ≥ 1.5 cm: FNA

• cancer risk: 9.1%

TR5

• ≥ 7 points

• highly suspicious

• ≥ 0.5 cm: follow-up annually for 5 years

• ≥ 1.0 cm: FNA

• cancer risk: 35%