Speciality Medical Dialogues
    • facebook
    • twitter
    Login Register
    • facebook
    • twitter
    Login Register
    • Medical Dialogues
    • Education Dialogues
    • Business Dialogues
    • Medical Jobs
    • Medical Matrimony
    • MD Brand Connect
    Speciality Medical Dialogues
    • Editorial
    • News
        • Anesthesiology
        • Cancer
        • Cardiac Sciences
        • Critical Care
        • Dentistry
        • Dermatology
        • Diabetes and Endo
        • Diagnostics
        • ENT
        • Featured Research
        • Gastroenterology
        • Geriatrics
        • Medicine
        • Nephrology
        • Neurosciences
        • Nursing
        • Obs and Gynae
        • Ophthalmology
        • Orthopaedics
        • Paediatrics
        • Parmedics
        • Pharmacy
        • Psychiatry
        • Pulmonology
        • Radiology
        • Surgery
        • Urology
    • Practice Guidelines
        • Anesthesiology Guidelines
        • Cancer Guidelines
        • Cardiac Sciences Guidelines
        • Critical Care Guidelines
        • Dentistry Guidelines
        • Dermatology Guidelines
        • Diabetes and Endo Guidelines
        • Diagnostics Guidelines
        • ENT Guidelines
        • Featured Practice Guidelines
        • Gastroenterology Guidelines
        • Geriatrics Guidelines
        • Medicine Guidelines
        • Nephrology Guidelines
        • Neurosciences Guidelines
        • Obs and Gynae Guidelines
        • Ophthalmology Guidelines
        • Orthopaedics Guidelines
        • Paediatrics Guidelines
        • Psychiatry Guidelines
        • Pulmonology Guidelines
        • Radiology Guidelines
        • Surgery Guidelines
        • Urology Guidelines
    LoginRegister
    Speciality Medical Dialogues
    LoginRegister
    • Home
    • Editorial
    • News
      • Anesthesiology
      • Cancer
      • Cardiac Sciences
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endo
      • Diagnostics
      • ENT
      • Featured Research
      • Gastroenterology
      • Geriatrics
      • Medicine
      • Nephrology
      • Neurosciences
      • Nursing
      • Obs and Gynae
      • Ophthalmology
      • Orthopaedics
      • Paediatrics
      • Parmedics
      • Pharmacy
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
    • Practice Guidelines
      • Anesthesiology Guidelines
      • Cancer Guidelines
      • Cardiac Sciences Guidelines
      • Critical Care Guidelines
      • Dentistry Guidelines
      • Dermatology Guidelines
      • Diabetes and Endo Guidelines
      • Diagnostics Guidelines
      • ENT Guidelines
      • Featured Practice Guidelines
      • Gastroenterology Guidelines
      • Geriatrics Guidelines
      • Medicine Guidelines
      • Nephrology Guidelines
      • Neurosciences Guidelines
      • Obs and Gynae Guidelines
      • Ophthalmology Guidelines
      • Orthopaedics Guidelines
      • Paediatrics Guidelines
      • Psychiatry Guidelines
      • Pulmonology Guidelines
      • Radiology Guidelines
      • Surgery Guidelines
      • Urology Guidelines
    • Home
    • Editorial
    • Ultrasound...

    Ultrasound classification of thyroid nodules : Role of TI-RADS

    Written by Anjali Nimesh Nimesh Published On 2018-02-26T19:05:41+05:30  |  Updated On 19 Aug 2021 5:02 PM IST

    Thyroid Imaging, Reporting and Data System, or TI-RADS, is formulated after the American College of Radiology's BI-RADS, a widely accepted risk stratification system for breast lesions which has been further modified by ACR( American College of Radiology) in 2017. However, the former has not gained equal popularity in usage among radiologists. Even when classified on ultrasound, most thyroid nodules are subjected to invasive histopathological examination.


    The American College of Radiology TI-RADS has five different categories for nodule appearance -- composition, echogenicity, shape, margins and echogenic foci.The point total determines the nodule's ACR TI-RADS level, which ranges from TR1, benign, to TR5, high suspicion of malignancy. Vascularity and elastography scoring are not given importance in classification.

































    TI-RADS follow-up recommendations
    CategoryFollow-up recommendations
    TR1: BenignNo FNA biopsy
    TR2: Not suspicious for malignancyNo FNA biopsy
    TR3: Mildly suspicious for malignancyFNA biopsy if nodule ≥ 2.5 cm; follow if ≥ 1.5 cm
    TR4: Moderately suspicious for malignancyFNA biopsy if nodule ≥ 1.5 cm; follow if ≥ 1 cm
    TR5: Highly suspicious for malignancyFNA biopsy if nodule ≥ 1 cm; follow if ≥ 0.5 cm

    CAD method based on textural and morphological features is capable of distinguishing between hot from cold nodules using routine ultrasound. According to a recent study (2018) published in AJR a ''Web-Based Tool for Standardized Reporting of Thyroid Ultrasound Studies'' could be useful in characterization,and follow-up of thyroid nodules.


    In our Indian scenario however, we face limitation of resources and time. It is thus not always possible to grade every thyroid nodule when multiple different types are encountered. Thus in my experience and as per literature, few basic features could aid in enabling us to handpick the ones which need further sampling or just follow up.


    Hypoechoic nodules regardless of size must be viewed with suspicion whereas small hyperechoic nodules are usually benign. Irregular, infiltrative margins, microcalcifications, extrathyroid extension and rapid increase in interval size are highly suspicious signs. Isoechoic nodules with cystic areas within them are usually harmless.




    Right lobe of thyroid in a young female shows hyperechoic nodule with hypoechoic peripheral halo and vascularity within it- benign features on ultrasound and proven same on FNAC.



    Image: Another benign cystic nodule in the above patient.



    Left lobe of thyroid in same patient shows hypoechoic nodule with scattered punctate calcifications within it and in surrounding thyroid gland- FNAC was advised in view of suspicious morphology which revealed papillary carcinoma.


    References:

    • Samuel A. Stewart, MuraliRajaraman, and Andreu F. Costa.Web-Based Tool for Standardized Reporting of Thyroid Ultrasound Studies,American Journal of Roentgenology, January 2018, Vol. 210, No. 1: pp. 39-42

    • http://www.uab.edu/news/research/item/8429-uab-led-blue-ribbon-committee-creates-ultrasound-scoring-system-for-thyroid-nodules-to-reduce-unnecessary-biopsies


    Dr. Niharika Prasad,


    The author is MD (Radiodiagnosis) and is Senior Resident, Dept of Radiology in All India Institute of Medical Sciences, AIIMS Patna. She is a member Editorial Board, Radiology at Specialty Medical Dialogues.

    Dr Niharika PrasadElastographyhyperechoic noduleshypoechoic peripheralNiharika PrasadradiologistThyroid Imagingthyroid noduleUltrasonographyUltrasoundVascularity

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    Anjali Nimesh Nimesh
    Anjali Nimesh Nimesh
      Show Full Article
      Next Story
      Similar Posts
      NO DATA FOUND

      • Email: info@medicaldialogues.in
      • Phone: 011 - 4372 0751

      Website Last Updated On : 12 Oct 2022 7:06 AM GMT
      Company
      • About Us
      • Contact Us
      • Our Team
      • Reach our Editor
      • Feedback
      • Submit Article
      Ads & Legal
      • Advertise
      • Advertise Policy
      • Terms and Conditions
      • Privacy Policy
      • Editorial Policy
      • Comments Policy
      • Disclamier
      Medical Dialogues is health news portal designed to update medical and healthcare professionals but does not limit/block other interested parties from accessing our general health content. The health content on Medical Dialogues and its subdomains is created and/or edited by our expert team, that includes doctors, healthcare researchers and scientific writers, who review all medical information to keep them in line with the latest evidence-based medical information and accepted health guidelines by established medical organisations of the world.

      Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription.Use of this site is subject to our terms of use, privacy policy, advertisement policy. You can check out disclaimers here. © 2025 Minerva Medical Treatment Pvt Ltd

      © 2025 - Medical Dialogues. All Rights Reserved.
      Powered By: Hocalwire
      X
      We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok