- To describe in a concise and practical way two of the most used ultrasound-based classification systems for thyroid nodules: the American College of Radiology (ACR) TIRADS,
and European (EU) TIRADS. -Stablish the principal differences between both classification systems and the pros and cons of both of them. - To show in a practical way,
by presenting common clinical cases,
the main differences between those systems. - Review the accumulated evidence.
Thyroid nodules are quite common in general population,
being found in up to 68% of normal population (depending the serie) .
Most of them are asymptomatic,
showing benign appearance,
and will never develop into a cancer.
But few of them could develop a cancer in a future.
Ultrasound (US) is widespread and extremely useful for imaging thyroid lesions,
given the fact that some US features of thyroid nodules has been linked to increased risk of malignancy in varying percentages....
Findings and procedure details
ACR-TIRADS Is a scoring system,
based in the US features of a given nodule.
The higher the score,
the greater the risk of malignancy,
which would imply performing complementary interventions (namely FNA) for a better characterization of the lesion.
Detailed description of the nodules features' and scores can be found in Figure 1. It stratifies nodules into the following suspiciongroups: Fig. 1 TR1: Benign: Cancer risk 0.3%.
In this case,
FNA is not indicated. TR2: Not suspicious: Cancer risk...
The ACR - TIRADS and EU-TIRADS are very good and useful scores to stratify the risk of malignancy of a determined thyroid lesion.
Owingthe differences between both scores,
we recommend using one of them and clearly state the used one in the radiological report to avoid confusion and offer an standardized management to patients.
 Tessler FN,
ACR Thyroid Imaging,
Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee.
J Am Coll Radiol.
2017 May;14(5):587-595. .