Abstract: Thyroid nodules are a common finding on clinical and radiological examination, and are a frequent source of anxiety for the patient and clinician. Fine needle aspiration (FNA) cytology is widely accepted as a safe, accurate, sensitive and cost-effective technique for assessment of thyroid nodules, however the majority of nodules are benign and do not warrant FNA. Over-diagnosis of thyroid cancers (those with a low likelihood of biologically significant malignancy) ranges from 45% to 80% of cases, and therefore, a simple, non-invasive, and cost-effective system of determining which thyroid nodules require FNA is desirable. In 2017 the American College of Radiology (ACR) presented the Thyroid Imaging, Reporting and Data System (TI-RADS), utilising appearances on ultrasound to risk stratify thyroid nodules based on their probability of being malignant. TI-RADS aids the diagnostician in identifying which nodules require biopsy or sonographic follow up, and aims to reduce the burden of unnecessary FNAs. In this educational poster we will provide a pictorial review of the various ultrasound features described in TI-RADS and aim to clarify the scoring and subsequent recommended treatment pathway as determined by a nodules TI-RADS level. Summary: A pictorial review of the TIRADS scoring system for thyroid nodules on ultrasound. References: All images used with creative commons from radiopaedia.org and statdx.com
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