TI-RADS: Meaning in a Radiology Report

TI-RADS is a points-based score for thyroid nodules on ultrasound. With the nodule's size, it guides whether a needle sample or follow-up is needed.

What it means

TI-RADS stands for Thyroid Imaging Reporting and Data System. In the widely used American College of Radiology (ACR) version, the radiologist gives points for five ultrasound features. These are what the nodule is made of (fluid or solid), how dark it looks, its shape, its edges and any bright spots inside. The total sets a level from TR1 (benign) to TR5 (highly suspicious). Other countries use similar systems with slightly different rules.

When it matters

Most thyroid nodules are benign, and most never need a needle test. The level and the size together decide the advice. A fine-needle aspiration (a sample taken with a thin needle) is advised from about 1 cm for TR5, 1.5 cm for TR4 and 2.5 cm for TR3. Smaller nodules at these levels may get follow-up ultrasounds instead. TR1 and TR2 nodules generally need no sample or follow-up.

Questions to ask your doctor

What level is my nodule, and which features gave it points?
Is my nodule big enough to need a needle sample, or just follow-up?
When should my next thyroid ultrasound be done?

General information, not medical advice. What a finding means for you depends on your symptoms, your history and the images themselves, so talk your results through with a doctor.