Thyroid imaging reporting and data system

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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