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SEER Inquiry System - Report
Produced: 02/17/2026 3:57 AM
Question 20210037
Inquiry Details
References:
American College of Radiology TI-RADS Reporting System
Question:
Reportability/Date of diagnosis--Thyroid: Is category Thyroid imaging reporting and data system (TI-RADS) 4 (4a/4b) or TI-RADS 5 on imaging diagnostic of thyroid cancer, and if so, can we use the date of the impression on the scan that states either of these categories as the diagnosis date?
Discussion:
Answer:
Answer revised 3/31/2022
Do not report cases based only on the TI-RADS category. The most recent information from ACR on TI-RADS indicates that neither TI-RADS 4 nor TI-RADS 5 is clearly defined as malignancy. TI-RADS 4 is "moderately suspicious" and TI-RADS 5 is "highly suspicious" but they do not specify what they are suspicious for. We need more information to determine reportability.
History:
Previous Answer
TI-RADS 5 is reportable for thyroid cancer unless disproven by other documentation and the date of the TI-RADS 5 scan may be used as the date of diagnosis if this is the earliest mention of the malignancy. TI-RADS 5 is "probably malignant nodules (>80% malignancy)."
TI-RADS 4 (including 4a and 4b) is not reportable for thyroid cancer. TI-RADS 4 is "suspicious nodules (5-80% malignancy)." TI-RADS 4b is "suspicious (10-80% malignancy)."
