TI-RADS Calculator

This tool provides a calculation based on the ACR TI-RADS classification system for thyroid nodules, as proposed by the ACR TI-RADS committee. Refer to the 2017 white paper for full details.

Explanatory Notes:

Spongiform: Composed predominantly (>50%) of small cystic spaces. Do not add further points for other categories.

Mixed cystic and solid: Assign points for predominant solid component.

Assign 2 points if composition cannot be determined because of calcification.

Anechoic: Applies to cystic or almost completely cystic nodules.

Hyperechoic/isoechoic/hypoechoic: Compared to adjacent parenchyma.

Very hypoechoic: More hypoechoic than strap muscles.

Assign 1 point if echogenicity cannot be determined.

Taller-than-wide: Should be assessed on a transverse image with measurements parallel to sound beam for height and perpendicular to sound beam for width.

This can usually be assessed by visual inspection.

Lobulated: Protrusions into adjacent tissue.

Irregular: Jagged, spiculated, or sharp angles.

Extrathyroidal extension: Obvious invasion = malignancy.

Assign 0 points if margin cannot be determined.

Large comet-tail artifacts: V-shaped, >1 mm, in cystic components.

Macrocalcifications: Cause acoustic shadowing.

Peripheral: Complete or incomplete along margin.

Punctate echogenic foci: May have small comet-tail artifacts.

For Reference:
2017 White Paper of the ACR TI-RADS Committee