Rating Thyroid US finding of Thyroid Cancer
Thyroid Nodule/Cancer - ATA 2015
| Score | Suspicious Level | FNA | Estimated risk of malignancy, % |
|---|---|---|---|
| 0-1 (TR1) | Benign | X | <1 |
| 2 (TR2) | Very low | if ≥ 2 cm (can also follow with US Q6 mon.) | <3 |
| 3 (TR3) | Mildly | if ≥ 1.5 cm | 5–10 |
| 4-6 (TR4) | Moderately | if ≥ 1 cm | 10–20 |
| 7+ (TR5) | Highly | if ≥ 1 cm | >70–90 |
| Sonographic pattern | US features |
|---|---|
| High suspicion (TR5) | Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, microlobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of ETE. |
”solid, hypoechoic, microcalcifications, irregular margins, taller-than-wide” | | Intermediate suspicion (TR4) | Hypoechoic solid nodule with smooth margins without microcalcifications, ETE, or taller than wide shape | | Low suspicion (TR3) | Isoechoic or hyperechoic solid nodule, or partially cystic nodule with eccentric solid areas, without microcalcification, irregular margin or ETE, or taller than wide shape. | | Very low suspicion (TR2) | Spongiform or partially cystic nodules without any of the sonographic features described in low, intermediate, or high suspicion patterns | | Benign (TR1) | Purely cystic nodules (no solid component) |