TI-RADS Note to Physicians
Thank you for your continued partnership with us in providing high quality healthcare to the people of Wake County and the Triangle. We value our relationship with you and are grateful for the opportunity to work alongside you.
We have been watching many of the developments in radiology centered around innovative ways to deliver high value care for our patients. As a result of the ACR’s multiple Committees on Incidental Findings a new committee was formed to investigate the management of thyroid nodules, led by Joanne Hoang MD of Duke University. In late 2015, this committee formed a structured reporting system for describing thyroid nodules, now known as TI-RADS (Thyroid Imaging Reporting and Data System). In 2017, a management algorithm was applied to the structure which has shown over subsequent studies to be an appropriate way to manage thyroid nodules based on their TIRADS score and sonographic imaging characteristics. Implementation of this system has resulted in more appropriate use of structured active surveillance and improved selective application of Fine Needle Aspiration recommendations. With TIRADS in place these improvements result in fewer unnecessary biopsies, improve the management of costs associated with thyroid nodules and help achieve the goal of providing a valuable service to our patients by applying the right study, to the right patient situation, at the right time.
Beginning April 1, 2018, you will see a change in the structure of our thyroid ultrasound reports. It will have a different appearance, better characterization of thyroid nodules and provide more concise management recommendations backed by the most recent science in the radiology literature.
We recognize that some nodules may present stratification challenges between TIRADS and previous systems such as the 2015 recommendations of the American Thyroid Association or the 2005 recommendations from the Society of Radiologists in Ultrasound. As always, we remain available to answer any questions and discuss management challenges and specific patient scenarios. In the coming weeks, further resources will be available on our website, and our marketing team will also have relevant literature for your review.
We are excited to add further value to the care we provide for the patients of Wake County.
As always, we’re available if you have questions.