Thyroid image reporting and data system (TIRADS) |
Thyroid image reporting and data system (TIRADS)
Dr Rupesh Namdev and Dr Praveen Jha et al.
TIRADS classification system is being advocated similar to BIRADS category for breast lesions. Although not accepted globally, it may help radiologists in classifying and risk stratification of thyroid lesions.
Classification system has been proposed by Horvath et al1, with a modified recommendation from Jin Kwak et al2.
Similar to BIRADS category, sonographic TIRADS classification is as follows-
TIRADS 1 - normal thyroid gland
TIRADS 2 - benign lesions
TIRADS 3 - probably benign lesions
TIRADS 4 - suspicious lesions (subclassified as 4a, 4b, and later 4c 2 with increasing risk of malignancy)
TIRADS 5 - probably malignant lesions (more than 80% risk of malignancy)
TIRADS 6 - biopsy proven malignancy
TIRADS 2 category
avascular anechoic lesion with echogenic specks (colloid type I)
vascular heteroechoic non-expansile, non-encapsulated nodules with peripheral halo (colloid type II)
isoechoic or heteroechoic, non-encapsulated, expansile vascular nodules (colloid type III)
These conditions have 0% risk of malignancy.
TIRADS 3 category
hyperechoic, iso-echoic or hypoechoic nodules, with partially formed capsule and peripheral vascularity, usually in setting of Hashimoto's thyroiditis (Hashimoto's pseudonodule)
Modified TIRADS classification2 have simplified TIRADS 3 category as none of the suspicious malignant sonographic features described below. These lesions are mostly benign with <5% risk of malignancy1.
TIRADS 4 and 5 categories
These categories are based on five suspicuous sonographic features of malignancy
solid component
markedly hypoechoic nodule
microlobulations or irregular margins
microcalcifications
taller-than-wider shape
TIRADS 4a - one suspicious feature
TIRADS 4b - two suspicious features
TIRADS 4c - 3-4 suspicious features
TIRADS 5 - all five suspicious features
TIRADS 4a has 5-10% risk of malignancy, 4b and 4c may have 10-80% risk of malignancy. TIRADS 5 category lesion have >80% risk of malignancy1.
http://radiopaedia.org/articles/thyroid-image-reporing-and-data-system-tirads
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