Table 2 American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) Classification
Ultrasound features | Description and points | |||
|---|---|---|---|---|
Composition (choose 1) | Cystic or almost completely cystic - 0 points | |||
Spongiform - 0 points | ||||
Mixed cystic and solid - 1 point | ||||
Solid or almost completely solid - 2 points | ||||
Echogenicity (choose 1) | Anechoic – 0 points | |||
Hyperechoic or isoechoic – 1 point | ||||
Hypoechoic – 2 points | ||||
Very hypoechoic – 3 points | ||||
Shape (choose 1) | Wider-than-tall – 0 points | |||
Taller-than-wide – 3 points | ||||
Margins (choose 1) | Smooth – 0 points | |||
Ill-defined – 0 points | ||||
Lobulated or irregular – 2 points | ||||
Extra-thyroidal extension – 3 points | ||||
Echogenic foci | None or large comet-tail artifacts – 0 points | |||
(choose all that apply) | Macrocalcifications – 1 point | |||
Peripheral (rim) calcifications – 2 points | ||||
Punctate echogenic foci – 3 points | ||||
TI-RADS Category (sum of points) | ||||
TR1 (0 points) Benign | TR2 (2 points) Not Suspicious | TR3 (3 points) Mildly suspicious | TR4 (4–6 points) Moderately suspicious TR4a – 4 points TR4b – 5 points TR4c – 6 points | TR5 (≥7 points) Highly suspicious |