ACR TI-RADS Calculator
Use this tirads calculadora to estimate an ACR TI-RADS score from thyroid ultrasound features and receive a size-based management suggestion.
Leave all unchecked if none are present, or if only comet-tail artifacts are present (0 points).
Educational tool only. Always confirm with a qualified clinician and your official radiology report.
What is TI-RADS?
TI-RADS stands for Thyroid Imaging Reporting and Data System. It is a standardized method radiologists use to describe thyroid nodules seen on ultrasound. Instead of vague language, TI-RADS turns ultrasound findings into points, then maps those points to a risk category (TR1 to TR5).
This helps answer practical questions such as:
- How suspicious does this nodule look?
- Should we simply observe it over time?
- Does it meet criteria for biopsy (FNA)?
How this tirads calculadora works
The calculator follows the ACR point framework across five ultrasound domains:
1) Composition
Nodules that are purely cystic or spongiform are usually less concerning. Solid nodules generally score higher.
2) Echogenicity
How bright or dark the nodule appears relative to thyroid tissue matters. Very hypoechoic nodules receive more points.
3) Shape
Taller-than-wide shape is more suspicious than wider-than-tall and therefore adds significant points.
4) Margin
Irregular or infiltrative margins are more concerning than smooth or ill-defined edges.
5) Echogenic foci
Calcification patterns can increase suspicion. In this calculator, suspicious foci are additive when multiple types are selected.
Scoring and category interpretation
| Total Points | Category | Typical Suspicion Level | Approximate Malignancy Risk |
|---|---|---|---|
| 0 | TR1 | Benign | Very low |
| 1–2 | TR2 | Not suspicious | Low |
| 3 | TR3 | Mildly suspicious | Low to intermediate |
| 4–6 | TR4 | Moderately suspicious | Intermediate |
| 7+ | TR5 | Highly suspicious | Higher |
Size thresholds often used for action
TI-RADS management decisions depend on both category and nodule size. Common ACR-style thresholds:
- TR1 / TR2: no FNA, usually no routine follow-up.
- TR3: follow-up if ≥1.5 cm; FNA if ≥2.5 cm.
- TR4: follow-up if ≥1.0 cm; FNA if ≥1.5 cm.
- TR5: follow-up if ≥0.5 cm; FNA if ≥1.0 cm.
Important clinical context
No online calculator should replace medical judgment. Final decisions should integrate:
- Formal ultrasound report and image quality
- Patient age, history, and risk factors
- Symptoms (voice change, compressive symptoms, lymph nodes)
- Prior scans and growth trend over time
- Endocrinology or radiology specialist recommendations
Quick tips for better use
- Use the exact feature wording from your radiology report when possible.
- Enter the largest diameter in centimeters (cm), not millimeters.
- If uncertain between two features, ask your clinician rather than guessing.
- Keep past results to monitor whether category or size changes over time.
In short, this tirads calculadora gives a clear and practical estimate of risk category and management direction. It is most useful as a discussion aid before or after your clinician visit.