ACR TI-RADS
ACR · 2017 · Updated 2017
Point-based risk stratification of thyroid nodules on US. TR1–TR5 classification and size cutoffs for FNA and follow-up.
Thyroid nodules incidentally or purposefully imaged with US in adults
Pediatric patients · Nodules already classified as Bethesda ≥ IV cytology · Diffuse thyroid disease without a nodule
US
ACR consensus — 2017
Sum points from five ultrasound categories (composition, echogenicity, shape, margin, echogenic foci) → TR level. FNA thresholds depend on TR level and nodule size.
Overview
Point-based risk stratification of thyroid nodules on US. TR1–TR5 classification and size cutoffs for FNA and follow-up.
Quick reference
| Level | FNA / follow-up |
|---|---|
| TR1 (0 pts) | No FNA or follow-up |
| TR2 (2 pts) | No FNA or follow-up |
| TR3 (3 pts) | FNA ≥ 2.5 cm · follow-up ≥ 1.5 cm |
| TR4 (4–6 pts) | FNA ≥ 1.5 cm · follow-up ≥ 1.0 cm |
| TR5 (≥7 pts) | FNA ≥ 1.0 cm · follow-up ≥ 0.5 cm |
Decision algorithm
TI-RADS point-based risk stratification and FNA thresholds.
Structured report
Interactive template that produces a validated dictation ready for the report.
References
- Tessler FN et al. JACR 2017
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(5):587-595.