ACR TI-RADS Recommendations: A Call to Contextualize Radiologists' Recommendations for Thyroid Nodules With the Clinical Scenario.

Abstract

The American College of Radiology incidental findings and Thyroid Imaging Reporting and Data System (TI-RADS™) committees have provided guidance for reporting findings and providing recommendations for the management of patients with thyroid nodules, and these interventions have significantly reduced performance of unnecessary thyroid biopsies [ 1 Hoang J.K. Langer J.E. Middleton W.D. et al. Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Coll Radiol. 2015; 12: 143-150 Abstract Full Text Full Text PDF PubMed Scopus (179) Google Scholar , 2 Tessler F.N. Middleton W.D. Grant E.G. 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: 587-595 Abstract Full Text Full Text PDF PubMed Scopus (711) Google Scholar ]. ACR guidance spans from incidental thyroid nodules detected on cross-sectional imaging and PET to categorization according to thyroid cancer risk for thyroid nodules evaluated on ultrasound with TI-RADS [ 1 Hoang J.K. Langer J.E. Middleton W.D. et al. Managing incidental thyroid nodules detected on imaging: white paper of the ACR Incidental Thyroid Findings Committee. J Am Coll Radiol. 2015; 12: 143-150 Abstract Full Text Full Text PDF PubMed Scopus (179) Google Scholar , 2 Tessler F.N. Middleton W.D. Grant E.G. 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: 587-595 Abstract Full Text Full Text PDF PubMed Scopus (711) Google Scholar ]. Evaluation and treatment of thyroid nodules are frequently not the primary concern of patients or of clinicians when they are discovered [ 3 Genere N. Hurtado M.D. Cortes T. et al. Drivers of the decision to biopsy and follow-up of small suspicious thyroid nodules. Endocr Pract. 2020; 26: 857-868 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar , 4 Singh Ospina N. Iniguez-Ariza N.M. Castro M.R. Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment. BMJ. 2020; 368: l6670 Crossref PubMed Scopus (26) Google Scholar ]. Thyroid nodule evaluation may have been born out of testing unrelated to the thyroid and often is ordered by primary care clinicians who are providing care for multiple other issues. Therefore, clinicians are quite appreciative of specific recommendations for thyroid nodule management according to imaging results.