What is the ACR TI-RADS calculator?

A tool that scores five thyroid-nodule ultrasound features — composition, echogenicity, shape, margin, and echogenic foci — and sums the points to assign an ACR TI-RADS category (TR1 to TR5) with a size-based biopsy or follow-up recommendation.

What do the TR1 to TR5 categories mean?

TR1 benign (~0.3% malignancy), TR2 not suspicious (~1.5%), TR3 mildly suspicious (~4.8%), TR4 moderately suspicious (~9.1%), and TR5 highly suspicious (~35%).

When is a thyroid biopsy (FNA) recommended?

Typical ACR thresholds: TR3 FNA at 2.5 cm or larger, TR4 at 1.5 cm or larger, and TR5 at 1.0 cm or larger. Smaller nodules in these categories are followed with ultrasound. TR1 and TR2 need no biopsy or follow-up.

Is this TI-RADS calculator a diagnosis?

No. It is an educational reference based on the ACR TI-RADS 2017 white paper and is not endorsed by the ACR. It does not replace assessment by a qualified radiologist or physician.

ACR TI-RADS · 2017 White Paper

Score a thyroid nodule in seconds.

Enter the five ultrasound features and nodule size to get the ACR TI-RADS category, estimated malignancy risk, and a size-based biopsy or follow-up recommendation.

Built for radiologists & residents Explained for patients

ACR TI-RADS · 2017 White Paper

TI-RADS Calculator

Score a thyroid nodule across five ultrasound features to get its ACR TI-RADS category, estimated malignancy risk, and a size-based biopsy or follow-up recommendation.

Total points

0pts

TR1

Benign

Recommendation

—

Complete the features

Select one option in each category above.

Educational use only. This calculator implements the ACR TI-RADS (2017) point system for reference and learning. It is not endorsed by the American College of Radiology and is not a substitute for professional clinical judgment. Management decisions must be made by a qualified radiologist, endocrinologist, or physician who integrates the full clinical picture. Do not use it to self-diagnose.

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