What this calculator does
Scores thyroid nodule composition, echogenicity, shape, margin, and echogenic foci.
Select one finding in each ACR feature group and enter nodule size to produce the total points and TI-RADS category.
Clinical scope
Use ACR TI-RADS for sonographic risk stratification of thyroid nodules. It scores five feature groups and uses nodule size with the resulting category to guide follow-up or fine-needle aspiration thresholds.
Applicability and exclusions
- The calculator is not intended for non-thyroid neck masses or findings described only on CT, MRI, or PET.
- Previously biopsied or treated nodules and clinically high-risk scenarios require correlation with pathology and clinical history.
Method and calculation logic
Add points for composition, echogenicity, shape, margin, and echogenic foci. The sum determines TR1-TR5; maximum diameter is then used for size-based management thresholds.
Interpretation table
| Points | Category | General interpretation |
|---|---|---|
| 0 | TR1 | Benign |
| 2 | TR2 | Not suspicious |
| 3 | TR3 | Mildly suspicious |
| 4-6 | TR4 | Moderately suspicious |
| 7 or more | TR5 | Highly suspicious |
Worked example
Case: Fictional example: a 1.2 cm solid, hypoechoic, wider-than-tall thyroid nodule with smooth margins and no echogenic foci.
Calculation: Composition 2 + echogenicity 2 + shape 0 + margin 0 + echogenic foci 0 = 4 points.
Interpretation: The example is TR4. The 1.2 cm size must then be compared with the current ACR follow-up and FNA thresholds.
How to use this calculator
- Complete the visible imaging and measurement fields. Required inputs are marked in the workbench.
- Review the calculated category, score, measurements, and any recommendation or warning.
- Copy the report-ready text only after checking the result against the complete examination and source guideline.
Calculator-specific questions
How is growth defined?
Use the ACR definition and compare measurements in the same planes; apparent small changes may reflect measurement variability.
Should every nodule be reported and followed?
No. Apply the ACR guidance for which nodules to report, follow, or sample, including the approach to multiple nodules.
Are patient measurements sent to RadPhrases?
No. Calculator inputs and results are processed in the browser and are not submitted by this page.