ACR TI-RADS (Thyroid Nodule)

Standard ACR TI-RADS (Tessler 2017) and AI-Optimized TI-RADS (Wildman-Tobriner 2019)

How to Use

  • Pick the variant (Standard ACR or AI-Optimized).
  • Score every category. Composition Cystic / Spongiform auto-assigns TR1.
  • Echogenic foci is the only multi-select category — points add together.
  • Optionally enter the nodule's maximum diameter (cm) for a personalized FNA / follow-up recommendation.
Standard scoring per Tessler 2017. Switch to the AI variant (Wildman-Tobriner 2019) to zero-out six features that improve specificity and reduce unnecessary biopsies.
Report Details (optional — only used for the full report)

These fields appear in the structured report only. They never affect the live TR score. Leave anything blank and the report keeps its bracketed placeholder text for you to fill in later.

Copy a one-line impression or the full structured report (matching the standard TI-RADS template) to your clipboard.

About this calculator

Standard ACR TI-RADS (Tessler et al., 2017) scores five ultrasound feature categories on a thyroid nodule and assigns a TR level (TR1-TR5) plus FNA and follow-up size cutoffs. AI-Optimized TI-RADS (Wildman-Tobriner et al., 2019) keeps the same five categories and TR thresholds but reassigns six features to 0 points to improve specificity and reduce unnecessary biopsies, while preserving sensitivity.

  • Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017;14(5):587-595. doi:10.1016/j.jacr.2017.01.046
  • Wildman-Tobriner B, Buda M, Hoang JK, et al. Using Artificial Intelligence to Revise ACR TI-RADS Risk Stratification of Thyroid Nodules. Radiology. 2019;292(1):112-119. doi:10.1148/radiol.2019182128
  • Bozkuş A, Başar Y, Güven K. Comparison of the diagnostic performance of the artificial intelligence-based TIRADS algorithm with established classification systems for thyroid nodules. Diagn Interv Radiol. 2025. doi:10.4274/dir.2025.253428
  • Buda M. AI TI-RADS system optimized using genetic algorithm. github.com/mateuszbuda/AI-TI-RADS

For educational and reference purposes only. Always consult a qualified radiologist for clinical decisions.