Using an online calculator (www.TIRADSCalculator.com) for Thyroid Imaging, Reporting and Data System (TI-RADS) with images and descriptions of each of the ultrasound features as a clinical and educational tool to guide management of incidental thyroid nodules.
Thyroid nodules are common, with a prevalence of up to 68% of adults on ultrasound (1). Fine needle aspiration (FNA) is the most effective test in determining of a thyroid nodule is malignant and occasionally surgery is required to achieve a definitive diagnosis. But most thyroid nodules are benign and not all nodules require FNA or surgery. Over diagnosis of thyroid cancer results in many detected thyroid cancers without affecting mortality between 45 to 80% of cases. Recent attention has been focused on developing a non-invasive system, called Thyroid Imaging, Reporting and Data System (TI-RADS), with the use of ultrasound for risk stratification of thyroid nodules to identify clinically significant malignancies while reducing the number of biopsies performed on benign nodules.
The American College of Radiology (ACR) released a white paper in 2017 on the use of the TI-RADS. TI-RADS is based on ACR recommended standardized terms for ultrasound reporting of thyroid nodules (2). Selected ultrasound features of thyroid nodules are combined into a score to identify nodules that warrant biopsy or sonographic follow-up. The use of TI-RADS to risk stratify incidental nodules may result in fewer unnecessary biopsies (3). In order to facilitate the use of TI-RADS, an online calculator was developed. To serve as an educational and clinical tool, images demonstrating each of the ultrasound features are included in the online calculator.
An online calculator was developed for TI-RADS based on the ACR white paper in 2017 to facilitate the application of TI-RADS in clinical practice. Images and description of each of the ultrasound features of thyroid nodules are included to serve as an educational and clinical tool on the use of TI-RADS. Using TI-RADS in ultrasound based risk stratification of incidental thyroid nodules will guide management and potentially reduce unnecessary thyroid biopsies and interventions.