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. 2020 Dec 9;40(4):474–485. doi: 10.14366/usg.20148

Fig. 4. Modified K-TIRADS 4A nodules with isoechoic or partially cystic US pattern and one suspicious US feature in a 39-year-old woman (A) and in a 46-year-old woman (B).

Fig. 4.

A. Transverse US shows a solid and isoechoic nodule (14 mm) with punctate echogenic focus (microcalcification) (arrow) in the right thyroid lobe. This nodule is classified as high-risk by the AACE/ACE/AME guideline, moderately suspicious (TR4) by the ACR TI-RADS, an unclassified nodule by the ATA guideline, high-risk (TIRADS 5) by the EU-TIRADS, and intermediate suspicion (TIRADS 4) by the K-TIRADS. Final diagnosis: nodular hyperplasia by surgery. B. Transverse US shows a partially cystic and mildly hypoechoic nodule (12 mm) with an intrasolid punctate echogenic focus (microcalcification) (arrow) in the right thyroid lobe. This nodule is classified as high-risk by the AACE/ACE/AME guideline, moderately suspicious (TR4) by ACR TI-RADS, high suspicion by the ATA guideline, high-risk (TIRADS 5) by the EU-TIRADS, and intermediate suspicion (TIRADS 4) by the K-TIRADS. Final diagnosis: nodular hyperplasia by two benign findings on fine-needle aspiration and core needle biopsy. K-TIRADS, Korean Thyroid Imaging Reporting and Data System; US, ultrasonography; AACE, American Association of Clinical Endocrinologists; ACE, American College of Endocrinology; AME, Associazione Medici Endocrinologi; ACR TI-RADS, American College of Radiology Thyroid Imaging Reporting and Data System; ATA, American Thyroid Association; EU-TIRADS, European Thyroid Imaging Reporting and Data System.