Partial analysis at the time of publication showed rates of 20% for TR5 nodules. The projected risk of malignancy in the original 2017 paper 1 was based on partial analysis of 3433 nodules with cytological results. If the ACR TI-RADS level increases between scans, an interval scan the following year is again recommended. Interval enlargement on follow-up is significant if there is an increase of >20% and >2 mm in two dimensions or a >50% increase in volume. If there are multiple nodules, the two with the highest ACR TI-RADS scores should be sampled (rather than the two largest), with largest size being used a tie-breaker if there are multiple nodules of the same classification. Scoring and classificationįNA biopsy is recommended for suspicious lesions (TR3-TR5) with the above size criteria. If these features are present no further points will be added (automatically TR1). * Predominantly cystic or spongiform nodules are inherently benign. The findings in each category were detailed in the ACR committee's 2015 publication on a reporting lexicon 2. If multiple nodules are present only the four highest-scoring nodules (not necessarily the largest) should be scored, reported, and followed up.
peripheral/rim calcifications: 2 points.shape: (choose one) (assessed on the transverse plane)Īny and all findings in the final category are also added to the other four scores.solid or almost completely solid: 2 points.cystic or completely cystic *: 0 points.One score is assigned from each of the following categories: Scoring is determined from five categories of ultrasound findings (figure 2). The higher the cumulative score, the higher the TR (TI-RADS) level and the likelihood of malignancy.
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