Quick answer
The TIRADS score assesses, on ultrasound, the risk of malignancy of a thyroid nodule. A TIRADS 3 or 4 score does not mean cancer, but most often warrants surveillance or fine-needle aspiration depending on the size of the nodule, to clarify its nature.
What is the TIRADS score?
TIRADS (Thyroid Imaging Reporting and Data System) is an ultrasound classification system that assesses the risk of malignancy of a thyroid nodule. It helps decide whether simple surveillance is enough or whether further tests (fine-needle aspiration) are needed.
What does a TIRADS 3 or 4 score mean?
A TIRADS 3 score corresponds to a low risk of malignancy; a TIRADS 4 score corresponds to an intermediate risk. These categories do not mean the nodule is a cancer, but they most often warrant ultrasound surveillance or fine-needle aspiration depending on the size of the nodule.
And after the fine-needle aspiration result?
Thyroid fine-needle aspiration is classified using the Bethesda system, which guides management: simple surveillance, repeat aspiration, or active treatment depending on the category obtained.
Frequently asked questions
Is a TIRADS 4 nodule a cancer?
Can a benign thyroid nodule be treated without surgery?
Treatment of benign thyroid nodules by radiofrequency, without surgery and without a scar.
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Written by the Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by a radiologist of the department. Last updated: August 2026.