Guideline decision tool · Radiology
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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.

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Computed locally — no data uploaded. For licensed clinicians.
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Guideline-based

Implements the decision logic from published clinical guidelines.

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Runs in your browser

No installation. Enter the patient's values and get a guideline recommendation instantly.

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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.

CompositionMixed cystic-solid (1)
EchogenicityHyper-/iso-echoic (1)
Shape (aspect ratio)Wider-than-tall, ratio < 1 (0)
MarginLobulated / irregular (2)
Echogenic foci: macrocalcifications (+1)Yes
Echogenic foci: peripheral/rim calcifications (+2)Yes
Echogenic foci: punctate echogenic foci / microcalcifications (+3)Yes
Maximum nodule diameter1.2 cm

→DispositionFNA recommended

  • TI-RADS total:10 points
  • Level:TR5 (Highly suspicious (≥ 20%))
  • Max diameter:1.2 cm
CompositionCystic / spongiform (0)
EchogenicityAnechoic (0)
Shape (aspect ratio)Wider-than-tall, ratio < 1 (0)
MarginSmooth / 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 diameter1.2 cm

→DispositionUltrasound follow-up recommended

  • TI-RADS total:6 points
  • Level:TR4 (Moderately suspicious (5–20%))
  • 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.

Does Thyroid Nodule ACR TI-RADS & FNA Decision upload patient data? Where is it calculated?

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

How is Thyroid Nodule ACR TI-RADS & FNA Decision calculated in practice? Can you show a worked example?

Inputs: Composition Mixed cystic-solid (1), Echogenicity Hyper-/iso-echoic (1), Shape (aspect ratio) Wider-than-tall, ratio < 1 (0), Margin Lobulated / irregular (2), 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 FNA recommended(TI-RADS total: 10 points, Level: TR5 (Highly suspicious (≥ 20%)), Max diameter: 1.2 cm) 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)

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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.

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