Tirads Calculator
ACR TI-RADS points
4
ACR TI-RADS Calculator
TI-RADS level
TR4
Risk category
TR4 - Moderately suspicious
ACR recommendation
Fine-needle aspiration: TR4 at 1.5 cm is at or above the 1.5 cm threshold.
FNA at or above
1.50 cm
Follow-up at or above
1.00 cm
Follow-up schedule
Follow-up ultrasound at 1, 2, 3 and 5 years.
Composition points
2
Echogenicity points
2
Shape points
0
Margin points
0
Echogenic foci points
0
Worked out from 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 and 3 other sources.
A reporting aid for a qualified radiologist, not a diagnosis. The ACR TI-RADS categories rest on the reader’s own assessment of the ultrasound features, and the recommendation it produces is a starting point that clinical context, patient risk factors and the reporting radiologist override. It has not been reviewed here by a radiologist.
How this is worked out
8 steps
- Composition - Solid or almost completely solid: 2 pt.
- Echogenicity - Hypoechoic: 2 pt.
- Shape - Not taller-than-wide: 0 pt.
- Margin - Smooth: 0 pt.
- Echogenic foci - none (0 pt): 0 pt in total (these are additive, not a single choice).
- Total = 2 + 2 + 0 + 0 + 0 = 4 points.
- 4 points is TR4 (Moderately suspicious) on the ACR chart.
- Fine-needle aspiration: TR4 at 1.5 cm is at or above the 1.5 cm threshold.
Point breakdowntable
| category | finding | points |
|---|---|---|
| Composition | Solid or almost completely solid | 2 |
| Echogenicity | Hypoechoic | 2 |
| Shape | Not taller-than-wide | 0 |
| Margin | Smooth | 0 |
| Echogenic foci | none (0 pt) | 0 |
Results are general information, not financial, tax, legal, medical or engineering advice.