Difference between revisions of "Thyroid imaging reporting and data system"

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'''Thyroid imaging reporting and data system''', abbreviated '''TIRADS''', is a standardized system for reporting thyroid radiology.<ref>{{Cite journal  | last1 = Russ | first1 = G. | last2 = Leboulleux | first2 = S. | last3 = Leenhardt | first3 = L. | last4 = Hegedüs | first4 = L. | title = Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. | journal = Eur Thyroid J | volume = 3 | issue = 3 | pages = 154-63 | month = Sep | year = 2014 | doi = 10.1159/000365289 | PMID = 25538897 }}</ref>
'''Thyroid imaging reporting and data system''', abbreviated '''TIRADS''' and '''TI-RADS''', is a standardized system for reporting thyroid radiology.<ref>{{Cite journal  | last1 = Russ | first1 = G. | last2 = Leboulleux | first2 = S. | last3 = Leenhardt | first3 = L. | last4 = Hegedüs | first4 = L. | title = Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. | journal = Eur Thyroid J | volume = 3 | issue = 3 | pages = 154-63 | month = Sep | year = 2014 | doi = 10.1159/000365289 | PMID = 25538897 }}</ref>


==Scoring==
== ACR TIRADS ==
The scoring is broadly similar to the [[BI-RADS]] and consists of six possible categorizations.<ref name=pmid19276237>{{Cite journal  | last1 = Horvath | first1 = E. | last2 = Majlis | first2 = S. | last3 = Rossi | first3 = R. | last4 = Franco | first4 = C. | last5 = Niedmann | first5 = JP. | last6 = Castro | first6 = A. | last7 = Dominguez | first7 = M. | title = An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. | journal = J Clin Endocrinol Metab | volume = 94 | issue = 5 | pages = 1748-51 | month = May | year = 2009 | doi = 10.1210/jc.2008-1724 | PMID = 19276237 }}</ref>
The ''American College of Radiology'' (abbreviated ''ACR'') came out with a TIRADS version that is known as ''ACR TIRADS'' in 2017.<ref name=pmid28372962>{{cite journal |authors=Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, Cronan JJ, Beland MD, Desser TS, Frates MC, Hammers LW, Hamper UM, Langer JE, Reading CC, Scoutt LM, Stavros AT |title=ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee |journal=J Am Coll Radiol |volume=14 |issue=5 |pages=587–595 |date=May 2017 |pmid=28372962 |doi=10.1016/j.jacr.2017.01.046 |url=}}</ref>  It is often abbreviated ''TR''.<ref name=pmid31603734>{{cite journal |authors=Tappouni RR, Itri JN, McQueen TS, Lalwani N, Ou JJ |title=ACR TI-RADS: Pitfalls, Solutions, and Future Directions |journal=Radiographics |volume=39 |issue=7 |pages=2040–2052 |date=2019 |pmid=31603734 |doi=10.1148/rg.2019190026 |url=}}</ref>
 
{| class="wikitable sortable"
! ACR TIRADS
! Points
! Meaning
! Management
|-
| TR1
| 0 points
| benign
| No FNA
|-
| TR2
| 2 points
| benign finding(s)
| No FNA
|-
| TR3
| 3 points
| mildly suspicious for malignancy
| FNA if lesion >= 2.5 cm; follow-up if lesion >= 1.5 cm
|-
| TR4
| 4 to 6 points
| moderately suspicious for malignancy
| FNA if lesion >= 1.5 cm; follow-up if lesion >= 1.0 cm
|-
| TR5
| 7 or more points
| highly suspicious for malignancy
| FNA if lesion >= 1.0 cm; follow-up if lesion >= 0.5 cm
|-
|}
 
=="Original" TIRADS==
The original TIRADS is broadly similar to [[BI-RADS]] and consists of six possible categorizations:<ref name=pmid19276237>{{Cite journal  | last1 = Horvath | first1 = E. | last2 = Majlis | first2 = S. | last3 = Rossi | first3 = R. | last4 = Franco | first4 = C. | last5 = Niedmann | first5 = JP. | last6 = Castro | first6 = A. | last7 = Dominguez | first7 = M. | title = An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. | journal = J Clin Endocrinol Metab | volume = 94 | issue = 5 | pages = 1748-51 | month = May | year = 2009 | doi = 10.1210/jc.2008-1724 | PMID = 19276237 }}</ref>


{| class="wikitable sortable"  
{| class="wikitable sortable"  
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| often short follow-up
| often short follow-up
|-
|-
| 4
| 4
 
| suspicious abnormality  
| suspicious abnormality  
| needs biopsy
| needs biopsy  
|-
|-
| 5  
| 5  
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|}
|}


Note:
Notes:
*There is a ''French TIRADS'' with five categories.<ref name=pmid26324117>{{Cite journal  | last1 = Russ | first1 = G. | title = Risk stratification of thyroid nodules on ultrasonography with the French TI-RADS: description and reflections. | journal = Ultrasonography | volume = 35 | issue = 1 | pages = 25-38 | month = Jan | year = 2016 | doi = 10.14366/usg.15027 | PMID = 26324117 }}</ref>
*‡ Category 4 has been subdivided (see below).<ref name=pmid26324117>{{Cite journal  | last1 = Kwak | first1 = JY. | last2 = Han | first2 = KH. | last3 = Yoon | first3 = JH. | last4 = Moon | first4 = HJ. | last5 = Son | first5 = EJ. | last6 = Park | first6 = SH. | last7 = Jung | first7 = HK. | last8 = Choi | first8 = JS. | last9 = Kim | first9 = BM. | title = Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. | journal = Radiology | volume = 260 | issue = 3 | pages = 892-9 | month = Sep | year = 2011 | doi = 10.1148/radiol.11110206 | PMID = 21771959 }}</ref>
*There is a ''French TIRADS'' with five categories.<ref name=pmid26324117/>
 
===Subdivision of score 4===
Category 4 has been subdivided as per Kwak ''et al.'':<ref name=pmid26324117/>
{| class="wikitable sortable"
! Score
! Definition
! Risk of malignancy
|-
| 4a
| one suspicious feature
| 3.3%
|-
| 4b
| two suspicious features
| 9.2%
|-
| 4c
| three or four suspicious features
| 44.4-72.4%
|}


==See also==
==See also==
Line 47: Line 105:


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


==External links==
==External links==

Latest revision as of 16:36, 6 August 2021

Thyroid imaging reporting and data system, abbreviated TIRADS and TI-RADS, is a standardized system for reporting thyroid radiology.[1]

ACR TIRADS

The American College of Radiology (abbreviated ACR) came out with a TIRADS version that is known as ACR TIRADS in 2017.[2] It is often abbreviated TR.[3]

ACR TIRADS Points Meaning Management
TR1 0 points benign No FNA
TR2 2 points benign finding(s) No FNA
TR3 3 points mildly suspicious for malignancy FNA if lesion >= 2.5 cm; follow-up if lesion >= 1.5 cm
TR4 4 to 6 points moderately suspicious for malignancy FNA if lesion >= 1.5 cm; follow-up if lesion >= 1.0 cm
TR5 7 or more points highly suspicious for malignancy FNA if lesion >= 1.0 cm; follow-up if lesion >= 0.5 cm

"Original" TIRADS

The original TIRADS is broadly similar to BI-RADS and consists of six possible categorizations:[4]

Score Meaning Typical management
0 incomplete come back for more imaging
1 negative
2 benign finding(s)
3 probably benign often short follow-up
4 ‡ suspicious abnormality needs biopsy
5 highly suggestive of malignancy biopsy to confirm impression
6 pathologist says there is a malignancy excision

Notes:

  • ‡ Category 4 has been subdivided (see below).[5]
  • There is a French TIRADS with five categories.[5]

Subdivision of score 4

Category 4 has been subdivided as per Kwak et al.:[5]

Score Definition Risk of malignancy
4a one suspicious feature 3.3%
4b two suspicious features 9.2%
4c three or four suspicious features 44.4-72.4%

See also

References

  1. Russ, G.; Leboulleux, S.; Leenhardt, L.; Hegedüs, L. (Sep 2014). "Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup.". Eur Thyroid J 3 (3): 154-63. doi:10.1159/000365289. PMID 25538897.
  2. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, Cronan JJ, Beland MD, Desser TS, Frates MC, Hammers LW, Hamper UM, Langer JE, Reading CC, Scoutt LM, Stavros AT (May 2017). "ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee". J Am Coll Radiol 14 (5): 587–595. doi:10.1016/j.jacr.2017.01.046. PMID 28372962.
  3. Tappouni RR, Itri JN, McQueen TS, Lalwani N, Ou JJ (2019). "ACR TI-RADS: Pitfalls, Solutions, and Future Directions". Radiographics 39 (7): 2040–2052. doi:10.1148/rg.2019190026. PMID 31603734.
  4. Horvath, E.; Majlis, S.; Rossi, R.; Franco, C.; Niedmann, JP.; Castro, A.; Dominguez, M. (May 2009). "An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management.". J Clin Endocrinol Metab 94 (5): 1748-51. doi:10.1210/jc.2008-1724. PMID 19276237.
  5. 5.0 5.1 5.2 Kwak, JY.; Han, KH.; Yoon, JH.; Moon, HJ.; Son, EJ.; Park, SH.; Jung, HK.; Choi, JS. et al. (Sep 2011). "Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk.". Radiology 260 (3): 892-9. doi:10.1148/radiol.11110206. PMID 21771959.

External links