ACR TI-RADS
Thyroid · Ultrasound
Thyroid Imaging Reporting and Data System — points-based risk stratification of thyroid nodules with size-based FNA thresholds.
🧮 TI-RADS Points Calculator
Composition
Echogenicity
Shape
Margin
Echogenic foci (sum all that apply)
Total points
0
TR1
Benign (0 points)
Management: No FNA.
Estimated malignancy: ~0.3%
FNA thresholds are size-dependent; correlate the nodule’s maximum diameter with the TR level. Decision support only.
Categories & management
| Category | Meaning | Malignancy | Management |
|---|---|---|---|
| TR1 | Benign (0 points) | ~0.3% | No FNA. |
| TR2 | Not suspicious (2 points) | ~1.5% | No FNA. |
| TR3 | Mildly suspicious (3 points) | ~4.8% | FNA if ≥2.5 cm; follow if ≥1.5 cm. |
| TR4 | Moderately suspicious (4–6 points) | ~9.1% | FNA if ≥1.5 cm; follow if ≥1.0 cm. |
| TR5 | Highly suspicious (≥7 points) | ~35% | FNA if ≥1.0 cm; follow if ≥0.5 cm. |
Reference: Tessler FN et al., ACR TI-RADS, JACR 2017.. Decision support only — confirm against current ACR documents and apply clinical judgment.