TIRADS

[Linh]

Hi Steve,

For TIRADS grading nodules with complete eggshell calcification, how many points would you give? I feel like giving it points to hypoechogenicity, solid composition and peripheral rim calc would be an overcall as it will turn out to be a TIRADS 4 lesion. I think these lesions are very benign looking. What is your view on this?

Best regards,
Linh

[Stephen Bird]

Hi Linh,

There are rules for this in the Tirads system,

Tirads has a couple of supporting documents which are fabulous to read as they explain all of these small issues and provide guidance,

I must get around to recording my thyroid lecture soon as I think it will be helpful.

The Tirads rules say that if you cannot see the internal architecture of a lesion due to complete or near complete egg shell calcification you do the following :

Assume it is solid (2 points)
Assume it is isoechoic ( 1 point)
Allocate peripheral calcification points (2 points)

So they get 5 points.

I agree with you that these are often benign and often there is evidence they have been there for ages unchanged,

But they are the RULES !!!!

Steve

[Linh]

Phewww, still TIRADS 4. I’m good 🙂

I’m glad there are rules since we can all be on the same page.

Thanks Steve!

[Stephen Bird]

Tirads is all about the devil in the detail the is in the supporting articles.

Steve

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