Thyroid nodules are a frequent finding on neck sonography. Most nodules are benign; therefore, many nodules are biopsied to identify the small number that are malignant or require surgery for a definitive diagnosis. Since 2009, many professional societies and investigators have proposed ultrasound-based risk stratification systems to identify nodules that warrant biopsy or sonographic follow-up.
Because some of these systems were founded on the BI-RADS classification that is widely used in breast imaging, their authors chose to apply the acronym TI-RADS, for Thyroid Imaging, Reporting and Data System. In 2012, the ACR convened committees to (1) provide recommendations for reporting incidental thyroid nodules, (2) develop a set of standard terms (lexicon) for ultrasound reporting, and (3) propose a TI-RADS on the basis of the lexicon.
Doppler has not found to be useful in distinguishing benign from malignant lesions, however, the presence of vascularity rules out debris and hemorrhage which are inconsequential. The presence of “halo” is not specific and is not included in the lexicon. There is no mention of the role of thyroid elastography in the guidelines.
Ref: 1. Radiology Assistant 2. Radiogyan.com 3. ACR guidelines.
