When you get your thyroid ultrasound report, you may see the description “TI-RADS” score in the conclusion section. The “TI-RADS” is a system for grading the malignancy of thyroid nodules.
The doctor gives a score between 0 and 6 according to the table below, after combining the various ultrasound presentations of thyroid nodules. The different scores have different meanings and imply different responses.
| Table 1: Thyroid nodules TI-RADS score and meaning | |
|
Meaning |
|
|
0 |
Unable to assess, further examination required |
|
1 |
“Negative”, which means no nodules were found and no further testing is needed |
|
Benign nodules, predominantly cystic or solid, with regular morphology and clear borders, or with typical benign nodule features. No further examination is needed, clinical observation is sufficient |
|
|
3 |
Probably benign (generally less than 5% malignant), without typical malignant features. Review in 6 to 12 months is recommended |
|
4 |
Probably malignant, with one or more features of a malignant nodule, which can be subdivided into 4A, 4B, and 4C, with a progressively higher probability of malignancy; Patients with a “score of 4” usually require close follow-up (every 3 months) or further evaluation, including ultrasound-guided fine-needle aspiration biopsy, and may require surgical treatment |
|
5 |
Highly suspicious for malignancy (80% to 90% probability), requiring further evaluation (e.g., fine needle aspiration) or surgery |
|
6 |
Thyroid cancer that has been confirmed by fine needle aspiration |
Remind you that the judgment of ultrasound results is somewhat subjective. Therefore patients may not get consistent grading results from ultrasound exams done at different hospitals.
Co-written by Dr. Naisi Huang, Cancer Hospital, Fudan University