From the Guidelines
A TIRADS-3 lesion is a thyroid nodule that is classified as having a low suspicion for malignancy, with an estimated cancer risk of about 5%. This classification is part of the Thyroid Imaging Reporting and Data System, which standardizes the reporting of thyroid ultrasound findings 1. TIRADS-3 nodules typically have some mildly suspicious ultrasound features but lack highly concerning characteristics. These nodules are usually solid or partially solid with isoechoic or hyperechoic appearance, may have regular margins, and generally do not show microcalcifications or aggressive growth patterns.
Key Characteristics of TIRADS-3 Lesions
- Solid or partially solid composition
- Isoechoic or hyperechoic appearance on ultrasound
- Regular margins
- Lack of microcalcifications or aggressive growth patterns
For TIRADS-3 nodules, fine needle aspiration (FNA) biopsy is typically recommended if the nodule is larger than 1.5 cm, while smaller nodules can be monitored with follow-up ultrasound examinations 1. The follow-up interval is usually 6-12 months initially, with less frequent monitoring if the nodule remains stable. This approach balances the need to identify potential cancers while avoiding unnecessary procedures for what are most likely benign conditions.
Management Approach
- FNA biopsy for nodules larger than 1.5 cm
- Follow-up ultrasound examinations for smaller nodules
- Initial follow-up interval: 6-12 months
- Less frequent monitoring if the nodule remains stable
The TIRADS system helps clinicians make evidence-based decisions about which thyroid nodules require further evaluation and which can be safely monitored 1. However, the management of small thyroid nodules can be complex, and coordinated guidelines are needed to address the discrepancies between different recommendations 1.
From the Research
Definition of TIRADS-3 Lesion
- A TIRADS-3 lesion refers to a thyroid nodule that is classified as having a low suspicion of malignancy based on the Thyroid Imaging Reporting and Data System (TIRADS) 2, 3.
- The TIRADS system is a risk stratification model that uses ultrasound features to differentiate between benign and malignant thyroid nodules 2.
- A TIRADS-3 classification indicates that the nodule has a relatively low risk of malignancy, but still requires careful evaluation and possibly fine-needle biopsy to determine its nature 3.
Characteristics of TIRADS-3 Lesions
- TIRADS-3 lesions are typically characterized by a low echodensity, but lack other suspicious features such as microcalcifications, irregular borders, or intense vascularization 4.
- The proportion of malignancies among nodules with TIRADS 3 classification is relatively low, around 2.87% 3.
- Fine-needle aspiration biopsy (FNAB) may be recommended for TIRADS-3 lesions, especially if they are large or have other suspicious features 5, 6.
Clinical Significance of TIRADS-3 Lesions
- TIRADS-3 lesions are generally considered to have a low risk of malignancy, but still require regular follow-up and monitoring to ensure that they do not change or grow over time 2, 3.
- The TIRADS system helps to identify nodules that are likely to be benign, reducing the need for unnecessary fine-needle biopsies and thyroid surgery 2, 5.
- However, it is essential to note that a TIRADS-3 classification does not completely exclude the possibility of malignancy, and further evaluation and monitoring may be necessary to confirm the nature of the nodule 3, 6.