Composition | Echogenicity | Shape | Margin | Echogenic foci | |||||
Cystic or almost completely cystic | 0 | Anechoic | 0 | Wider-than-tall | 0 | Smooth | 0 | None or large comet-tail artifacts | 0 |
Spongiform | 0 | Hyperechoic or isoechoic | 1 | Taller-than-wide | 3 | Ill-defined | 0 | Macrocalcifications | 1 |
Mixed cystic and solid | 1 | Hypoechoic | 2 | Lobulated or irregular | 2 | Peripheral (rim) calcifications | 2 | ||
Solid or almost completely solid | 2 | Very hypoechoic | 3 | Extrathyroidal extension | 3 | Punctate echogenic foci | 3 | ||
Points | Malignancy risk (%) | FNA biopsy threshold (mm) | |||||||
TR1 | 0 | 0.3 | No biopsy | ||||||
TR2 | 2 | 1.5 | No biopsy | ||||||
TR3 | 3 | 4.8 | 25 | ||||||
TR4 | 4 to 6 | 9.1 | 15 | ||||||
TR5 | 7+ | 35.0 | 10 |
Original figure modified for this publication. 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; 14:587. Table used with the permission of Elsevier Inc. All rights reserved.
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