For educational and reference use only. These calculators do not replace clinical judgement, local protocols, or a qualified clinician. Verify every result independently before it informs patient care.
Body imaging
ACR TI-RADS
ACR Thyroid Imaging Reporting and Data System (2017) for a SINGLE nodule. Score five feature categories; the total maps to a TR level (TR1–TR5). Enter the nodule’s maximum diameter for size-based FNA / follow-up guidance, including the follow-up interval schedule. See the note for multiple-nodule and growth/comparison guidance.
TR1: Benign
No FNA or follow-up recommended.
Summary: 1 nodule
| # | TI-RADS | Points | Size | Action |
|---|---|---|---|---|
| 1 | TR1 | 0 | - | No FNA |
ACR multiple-nodule rule: characterise up to the four highest-TR nodules (largest within a level) and recommend FNA for no more than two. Ranked by TR level, then size. “FNA (priority)” marks those two; other FNA-eligible nodules are flagged for consideration.
Formula
Total = Composition + Echogenicity + Shape + Margin + Echogenic foci (additive). 0 → TR1, 2 → TR2, 3 → TR3, 4–6 → TR4, ≥7 → TR5. FNA/follow-up by TR level and size; follow-up US at TR3 1,3,5 yr · TR4 1,2,3,5 yr · TR5 annually to 5 yr.
Disclaimer
Scores a SINGLE nodule. With multiple nodules, score each separately: the ACR recommends following no more than the four with the highest point totals that fall below the FNA size threshold, and FNA of no more than the two highest that meet it, not every nodule. On follow-up, re-image and consider FNA if a nodule grows (≥20% in ≥2 dimensions and ≥2 mm, or ≥50% by volume) or develops new suspicious features; imaging can stop at 5 years if the size has not changed, and if the level rises the next scan is at 1 year whatever the level was. The asterisk on TR5 follow-up: the ACR recommends against routine biopsy below 1 cm even for TR5, but FNA of a 5–9 mm TR5 nodule may be appropriate by shared decision-making, and the report should say whether it can be measured reproducibly and whether it abuts the trachea or tracheo-oesophageal groove. TI-RADS does not override high-risk clinical features, abnormal nodes, or prior cytology.
For educational and reference use only. These calculators do not replace clinical judgement, local protocols, or a qualified clinician. Verify every result independently before it informs patient care.
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