TI-RADS Calculator
Thyroid Nodule Assessment
Enter the ultrasound features of your thyroid nodule to instantly calculate your ACR TI-RADS score. Understand your TR level and get clear guidelines on whether a biopsy or follow-up is needed.
Calculate Your TI-RADS Score
Select the features from your ultrasound report
What is the internal structure of the nodule?
How dark or light does the nodule appear?
What are the dimensions on the transverse plane?
How clear are the edges of the nodule?
Select all features that apply (you can pick multiple).
Your TI-RADS Category
What Is TI-RADS?
The Thyroid Imaging Reporting and Data System (TI-RADS), developed by the American College of Radiology (ACR), is a standardized method used by doctors and radiologists to assess thyroid nodules found during an ultrasound.
By assigning points based on five key ultrasound features—composition, echogenicity, shape, margin, and echogenic foci—it calculates a total score. This score helps determine the likelihood of the nodule being benign (harmless) or malignant, guiding your healthcare provider on whether a simple follow-up or a Fine Needle Aspiration (FNA) biopsy is required.
How Your Score is Interpreted
| TR Level | Points | Risk Level | FNA Biopsy Rules | Follow-up Rules |
|---|---|---|---|---|
| TR1 | 0 points | Benign | No FNA required | No follow-up needed |
| TR2 | 2 points | Not Suspicious | No FNA required | No follow-up needed |
| TR3 | 3 points | Mildly Suspicious | FNA if ≥ 2.5 cm | Follow-up if ≥ 1.5 cm |
| TR4 | 4 to 6 points | Moderately Suspicious | FNA if ≥ 1.5 cm | Follow-up if ≥ 1.0 cm |
| TR5 | 7 or more points | Highly Suspicious | FNA if ≥ 1.0 cm | Follow-up if ≥ 0.5 cm |
Composition
Describes what the nodule is made of. Fluid-filled (cystic) or sponge-like nodules are almost always harmless and score 0 points. Solid nodules score higher as they require more observation.
Echogenicity
Refers to how the nodule reflects sound waves on the ultrasound compared to normal thyroid tissue. "Hypoechoic" means it looks darker than surrounding tissue, which adds more points to the score.
Shape & Margins
A nodule that is taller than it is wide, or one that has irregular, jagged edges (margins), gets a higher score. Smooth, round nodules are generally less concerning.
Echogenic Foci
These are bright white spots seen inside the nodule, often indicating calcification. While some large spots are benign, tiny "punctate" spots score highest as they can warrant closer inspection.
Managing Your Thyroid Health at Home
- 1Consult an Endocrinologist — Your TI-RADS score is a tool, not a diagnosis. Always take your ultrasound report directly to an endocrinologist to discuss if you need a biopsy or just a yearly check-up.
- 2Focus on a Thyroid-Supportive Diet — What you eat plays a massive role in managing thyroid conditions, whether it's hypothyroidism or Hashimoto's. Include selenium-rich foods like sunflower seeds and iodine-rich foods moderately.
- 3Manage Other Conditions Together — Thyroid issues often go hand-in-hand with PCOD and insulin resistance. Structuring your diet to balance hormones and blood sugar is a practical step for a busy person. Cut back on highly processed foods.
- 4Be Mindful of Goitrogens — Foods like raw cabbage, cauliflower, and broccoli contain compounds that can interfere with thyroid function. Cooking these vegetables well helps reduce their goitrogenic effect.
- 5Don't Skip Your Follow-ups — If your doctor recommends an ultrasound in 12 months, set a calendar reminder right now. Consistent monitoring is the best way to catch any changes early.
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