Thyroid Nodule ACR TI-RADS & FNA Decision — free guideline decision tool
Score thyroid-nodule ultrasound features per ACR TI-RADS (TR1–5) and get an FNA or follow-up recommendation from the level and nodule size. Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Composition | Cystic / spongiform (0) |
|---|---|
| Echogenicity | Anechoic (0) |
| Shape (aspect ratio) | Wider-than-tall, ratio < 1 (0) |
| Margin | Smooth / ill-defined (0) |
| Echogenic foci: macrocalcifications (+1) | Yes |
| Echogenic foci: peripheral/rim calcifications (+2) | Yes |
| Echogenic foci: punctate echogenic foci / microcalcifications (+3) | Yes |
| Maximum nodule diameter | 1.2 cm |
→DispositionUltrasound follow-up recommended
- TI-RADS total：6 points
- Level：TR4 (Moderately suspicious (5–20%))
- Max diameter：1.2 cm
| Composition | Solid / almost completely solid (2) |
|---|---|
| Echogenicity | Very hypoechoic (3) |
| Shape (aspect ratio) | Taller-than-wide, ratio ≥ 1 (3) |
| Margin | Extra-thyroidal extension (3) |
| Echogenic foci: macrocalcifications (+1) | No |
| Echogenic foci: peripheral/rim calcifications (+2) | No |
| Echogenic foci: punctate echogenic foci / microcalcifications (+3) | No |
| Maximum nodule diameter | 1.2 cm |
→DispositionFNA recommended
- TI-RADS total：11 points
- Level：TR5 (Highly suspicious (≥ 20%))
- Max diameter：1.2 cm
Common questions
What is Thyroid Nodule ACR TI-RADS & FNA Decision?
Score thyroid-nodule ultrasound features per ACR TI-RADS (TR1–5) and get an FNA or follow-up recommendation from the level and nodule size. Instant, browser-side.
How is Thyroid Nodule ACR TI-RADS & FNA Decision calculated? What is the core formula?
Sum five features — composition, echogenicity, shape, margin, echogenic foci — into TR1 (0), TR2 (1–2), TR3 (3), TR4 (4–6), TR5 (≥ 7). FNA/follow-up thresholds: TR3 ≥ 2.5/1.5 cm, TR4 ≥ 1.5/1.0 cm, TR5 ≥ 1.0/0.5 cm.
When is Thyroid Nodule ACR TI-RADS & FNA Decision used?
Standardised malignancy-risk assessment of a thyroid nodule on ultrasound, with FNA/follow-up size thresholds.
What are the key clinical points for Thyroid Nodule ACR TI-RADS & FNA Decision?
Punctate echogenic foci (microcalcifications) add 3 points and strongly raise suspicion. ACR generally does not biopsy nodules < 1 cm even when TR5 (active surveillance is an option for 5–9 mm). With multiple nodules, assess the 1–2 with the highest TR rather than the largest. TR1–2 need no FNA; FNA vs follow-up depends on the size thresholds.
What are the limits and cautions when using Thyroid Nodule ACR TI-RADS & FNA Decision?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Thyroid Nodule ACR TI-RADS & FNA Decision calculated in practice? Can you show a worked example?
Inputs: Composition Cystic / spongiform (0), Echogenicity Anechoic (0), Shape (aspect ratio) Wider-than-tall, ratio < 1 (0), Margin Smooth / ill-defined (0), Echogenic foci: macrocalcifications (+1) Yes, Echogenic foci: peripheral/rim calcifications (+2) Yes, Echogenic foci: punctate echogenic foci / microcalcifications (+3) Yes, Maximum nodule diameter 1.2 cm → Result: Disposition Ultrasound follow-up recommended（TI-RADS total: 6 points, Level: TR4 (Moderately suspicious (5–20%)), Max diameter: 1.2 cm） Inputs: Composition Solid / almost completely solid (2), Echogenicity Very hypoechoic (3), Shape (aspect ratio) Taller-than-wide, ratio ≥ 1 (3), Margin Extra-thyroidal extension (3), Echogenic foci: macrocalcifications (+1) No, Echogenic foci: peripheral/rim calcifications (+2) No, Echogenic foci: punctate echogenic foci / microcalcifications (+3) No, Maximum nodule diameter 1.2 cm → Result: Disposition FNA recommended（TI-RADS total: 11 points, Level: TR5 (Highly suspicious (≥ 20%)), Max diameter: 1.2 cm）
Run Thyroid Nodule ACR TI-RADS & FNA Decision now
Score thyroid-nodule ultrasound features per ACR TI-RADS (TR1–5) and get an FNA or follow-up recommendation from the level and nodule size. Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.