Thyroid Nodule • Xray of the Week 2017 • Week #40
What is the TI-RADS Score of this nodule? What would you do next?
Figure 1: Thyroid Ultrasound. TI-RADS Scoring
Here is how I scored it:
Composition: Solid or almost completely solid - 2 points
Echogenicity: Hypoechoic - 2 points
Shape: Taller-than-wide - 3 points
Margin: Lobulated or irregular - 2 points
Echogenic Foci: Punctate echogenic foci - 3 points
TIRADS 5 - Highly Suspicious, Needs FNA.
Biopsy was performed and it showed thyroid papillary cancer.
Figure 2: Thyroid Ultrasound. Arrows showing the punctate echogenic foci.
The ACR Thyroid Imaging Reporting and Data System (TI-RADS) is a system that can take the guess work out of reading thyroid ultrasounds. The goal is to improve quality and decrease unnecessary biopsies.
Figure 3: ACR TI-RADS System
More TI-RADS Resources here: https://www.globalradcme.com/acr-tirads-resources
1. ACR TI-RADS ATLAS
2. Grant, E G, Tessler, FN, Hoang, JK, Langer, JE, Beland, MD, Berland, LL, Cronan JJ, Desser, TS, Frates, MC, Hamper, UM, Middleton, WD, Reading, CC, Scoutt, LM, Stavros, AT and Teefy, SA. (2015). Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. Journal of the American College of Radiology,12(12), 1272-1279. http://www.jacr.org/article/S1546-1440(15)00684-5/abstract
3. Franklin N. Tessler, MD, CMCorrespondence information about the author MD, CM Franklin N. TesslerEmail the author MD, CM Franklin N. Tessler, William D. Middleton, MD, Edward G. Grant, MD, Jenny K. Hoang, MBBS, Lincoln L. Berland, MD, Sharlene A. Teefey, MD, John J. Cronan, MD, Michael D. Beland, MD, Terry S. Desser, MD, Mary C. Frates, MD, Lynwood W. Hammers, DO, Ulrike M. Hamper, MD, Jill E. Langer, MD, Carl C. Reading, MD, Leslie M. Scoutt, MD, A. Thomas Stavros, MD ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. http://www.jacr.org/article/S1546-1440(17)30186-2/fulltext
Kevin Rice, MD serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is the Chief Compliance Officer of Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice co-founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field.
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