ACR TI-RADS (Thyroid Nodule)
ACR TI-RADS (Tessler 2017): additive point score from composition, echogenicity, shape, margin, and echogenic foci → TR1–TR5 level with a size-gated FNA / follow-up recommendation.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Composition
- Solid / almost completely solid (2)
- Echogenicity
- Very hypoechoic (3)
- Shape
- Wider-than-tall (0)
- Margin
- Smooth (0)
- Punctate echogenic foci
- Yes
- Maximum diameter
- 1.5
Result: 8 points → TR5; diameter 1.5 cm ≥ 1.0 cm → FNA.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Level → FNA
- TR1 0, TR2 1–2, TR3 3, TR4 4–6, TR5 ≥7. FNA/follow by diameter: TR3 ≥2.5/≥1.5, TR4 ≥1.5/≥1.0, TR5 ≥1.0/≥0.5 cm.
What you enter
- Composition
- Echogenicity
- Shape
- Margin
- Macrocalcifications
- Peripheral (rim) calcifications
- Punctate echogenic foci
- Maximum diameter (cm)
How this is calculated
- Points
- composition (0–2) + echogenicity (0–3) + shape (0/3) + margin (0/2/3) + echogenic foci (additive: macro 1, rim 2, punctate 3).
Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS committee. J Am Coll Radiol. 2017;14(5):587-595. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.