ACR TI-RADS Score Calculator
Use this tool to estimate an ACR TI-RADS category based on ultrasound features of a thyroid nodule.
Educational use only. Clinical decisions should be made by qualified healthcare professionals using full patient context and local guidelines.
What is a TI-RADS calculator?
A TI-RADS calculator helps classify thyroid nodules using standardized ultrasound features. TI-RADS stands for Thyroid Imaging Reporting and Data System. The ACR TI-RADS method assigns points to specific imaging findings, then maps the total score to a risk category (TR1 to TR5).
The goal is consistency: similar nodules should get similar recommendations regardless of who reads the scan. This improves communication between radiologists, endocrinologists, surgeons, and primary care teams.
How scoring works
ACR TI-RADS uses five feature groups. Each group contributes points:
- Composition (0–2 points)
- Echogenicity (0–3 points)
- Shape (0 or 3 points)
- Margin (0–3 points)
- Echogenic foci (0–3 points)
Add all points to get a total. That total determines the TI-RADS category.
| Total Points | Category | Interpretation | Typical Management Trigger* |
|---|---|---|---|
| 0 | TR1 | Benign | No FNA, no routine follow-up |
| 1–2 | TR2 | Not suspicious | No FNA, usually no routine follow-up |
| 3 | TR3 | Mildly suspicious | Follow-up ≥ 1.5 cm, FNA ≥ 2.5 cm |
| 4–6 | TR4 | Moderately suspicious | Follow-up ≥ 1.0 cm, FNA ≥ 1.5 cm |
| 7+ | TR5 | Highly suspicious | Follow-up ≥ 0.5 cm, FNA ≥ 1.0 cm |
*Thresholds shown are commonly used ACR TI-RADS size cutoffs. Clinical context still matters.
How to use this tirads calculator
Step 1: Enter ultrasound features
Choose one option in each feature group based on the ultrasound report. If you are not sure how to classify a feature, ask your radiologist for clarification rather than guessing.
Step 2: Add nodule size
Enter the largest nodule dimension in centimeters. TI-RADS category depends on imaging points, but management recommendation depends on both category and size.
Step 3: Review results
The calculator returns:
- Total TI-RADS points
- TR category (TR1–TR5)
- Estimated risk band
- General suggestion for follow-up or FNA threshold
Why TI-RADS is useful
- Reduces unnecessary biopsies for low-risk nodules
- Improves consistency across clinicians and centers
- Supports structured reporting and clearer communication
- Helps prioritize follow-up resources for higher-risk findings
Important limitations
No calculator can replace real clinical judgment. TI-RADS does not include every possible patient factor. A clinician may recommend a different plan based on symptoms, family history, prior radiation exposure, abnormal lymph nodes, or lab findings.
- Different guidelines (ACR, ATA, EU-TIRADS) may vary slightly
- Image quality and reader experience can affect scoring
- Nodule growth trend over time may influence management
- Patient preference may also be part of the decision
Bottom line
This tirads calculator is a practical way to convert ultrasound features into a standardized TI-RADS category and management threshold. It is best used as a support tool for education and discussion—not as a standalone diagnosis.