From the Research
The Thyroid Imaging, Reporting and Data System (TI-RADS) categorizes thyroid nodules on a scale from TR1 to TR5 based on specific ultrasound features, with TR1 being benign (0% risk of malignancy), TR2 not suspicious (less than 2% risk), TR3 mildly suspicious (5% risk), TR4 moderately suspicious (5-20% risk), and TR5 highly suspicious (greater than 20% risk of malignancy) 1.
Key Points
- The TI-RADS system helps standardize thyroid nodule management, reducing unnecessary biopsies while ensuring potentially malignant nodules are appropriately evaluated.
- The classification is based on nodule composition, echogenicity, shape, margin, and echogenic foci, with points assigned for suspicious features to generate the final TI-RADS category.
- The TI-RADS score determines whether fine needle aspiration (FNA) biopsy is recommended and at what nodule size threshold.
- For example, TR3 nodules may warrant FNA if ≥2.5cm or follow-up if ≥1.5cm, while TR4 nodules may warrant FNA if ≥1.5cm or follow-up if ≥1cm, and TR5 nodules should undergo FNA if ≥1cm or follow-up if ≥0.5cm 2.
TI-RADS Categories
- TR1: Benign (0% risk of malignancy)
- TR2: Not suspicious (less than 2% risk)
- TR3: Mildly suspicious (5% risk)
- TR4: Moderately suspicious (5-20% risk)
- TR5: Highly suspicious (greater than 20% risk of malignancy)
Clinical Implications
- The TI-RADS system can help identify which nodules should be investigated for potential malignancies, reducing unnecessary biopsies and improving patient outcomes 3.
- The system can also help standardize the management of thyroid nodules, ensuring that potentially malignant nodules are appropriately evaluated and treated 4.