Apr 11, 2024

SONOGRAPHIC PATTERN  SONOGRAPHIC FEATURES  ESTIMATED RISK OF MALIGNANCY  CONSIDER BIOPSY  High Suspicion  Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, micro lobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of extrathyroidal extension  > 70-90 ≥ 1 cm Intermediate suspicion  Hypoechoic solid nodule with smooth margins without micro calcifications, extrathyroidal extension, or taller than wide shape  10-20 ≥ 1 cm Low suspicion  Isoechoic or hyperechoic solid nodule or partially cystic nodule with eccentric solid areas without microcalcification, irregular margin or extrathyroidal extension, of taller than wide shape  5-10 ≥ 1.5 cm Very low suspicion  Spongiform or partially cystic nodules without any of the sonographic features described in low, intermediate, or high suspicion patterns  <3 ≥ 2 cm Benign  Purely cystic nodules (no solid component) <1 No Biopsy 
Also Read: Thyroid, Parathyroid And Adrenal Image Based Question
| 
 Breast imaging reporting and Database System (BI-RADS)  | 
|||
| 
 Category  | 
 Assessment  | 
 Probability of malignancy  | 
 Follow-up recommendation  | 
| 
 0  | 
 Assessment in incomplete  | 
 Not applicable  | 
 Need for additional imaging evaluation and/or prior mammograms of comparison  | 
| 
 1  | 
 Negative  | 
 Essentially 0%  | 
 Routine annaul screening mammography (for women over age 40)  | 
| 
 2  | 
 Beningn finding(s)  | 
 Essentially 0%  | 
 Routine annaul screening mammography (for women over age 40)  | 
| 
 3  | 
 Probably benign finding  | 
 >0% but ≤ 2%  | 
 Initial short-term follow up (Usually 6 months) examination  | 
| 
 4  | 
 Suspicious abnormality 4a: Finding needing intervention with a low suspicion for malignancy 4b: Intermediate suspicion of malignancy 4c: Findings of moderate concern, with high suspicion of malignancy  | 
>2 to ≤ 10% >10 to ≤ 50% >50% to < 95%  | 
 Biopsy should be considered  | 
| 
 5  | 
 Highly suggestive of malignancy  | 
 ≥ 95%  | 
 Requires biopsy or surgical treatment  | 
| 
 6  | 
 Know biopsy – proven malignancy  | 
 Not applicable  | 
 Category reserved for lesions identified on imaging study with biopsy proof of malignancy prior to definitive therapy  | 
Also Read: High-Yield NEET SS Surgery Breast and Endocrine Questions
Determining Characteristics Histologic Subtype Nuclear Grade Necrosis DCIS Grade Comedo High Extensive High Intermediate Intermediate Focal or Absent Intermediate Non comedo Low Absent Low 
Also Read: Prune Belly Syndrome (Eagle Belly Syndrome)
| 
 COMPOSITION (Choose 1) Cystic 0 Spongiform 0 Mixed cystic and solid 1 Solid 2  | 
 ECHOGENICITY (Choose 1) Anechoic 0 Hyperechoic or Isoechoic 1 Hypoechoic 2 Very Hypoechoic 3  | 
 SHAPE (Choose 1) Wider-than tall 0 Taller-than-wide 3  | 
 MARGIN (Choose 1) Smooth 0 Ill-defined 0 Lobulated or irregular 2 Extra-thyroidal extension 3  | 
 ECHOGENIC FOCI (Choose All that Apply None or large comet-tail artifacts Macrocalcifications Peripheral (rim) calcifications Punctate echogenic foci  | 
| 
 Add Points For TI-RADS level  | 
||||
| 
 0 Point  | 
 2 Points  | 
 3 Points  | 
 4 or 6 Points  | 
 7 Points or more  | 
| 
 TR1 Benign No FNA  | 
 TR2 Not Suspicious No FNA  | 
 TR3 Mildly Suspicious FNA if > 2.4 cm Follow if > 1.5 cm  | 
 TR4 Moderately Suspicious FNA if > 1.5 cm Follow if > 1 cm  | 
 TR5 Highly suspicious FNA if > 1 cm Follow if > 0.5 cm  | 
Also Read: Principle of Thyroid Surgery
SONOGRAPHIC PATTERN  SONOGRAPHIC FEATURES  ESTIMATED RISK OF MALIGNANCY  CONSIDER BIOPSY  High Suspicion  Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, micro lobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of extrathyroidal extension  > 70-90 ≥ 1 cm Intermediate suspicion  Hypoechoic solid nodule with smooth margins without micro calcifications, extrathyroidal extension, or taller than wide shape  10-20 ≥ 1 cm Low suspicion  Isoechoic or hyperechoic solid nodule or partially cystic nodule with eccentric solid areas without microcalcification, irregular margin or extrathyroidal extension, of taller than wide shape  5-10 ≥ 1.5 cm Very low suspicion  Spongiform or partially cystic nodules without any of the sonographic features described in low, intermediate, or high suspicion patterns  <3 ≥ 2 cm Benign  Purely cystic nodules (no solid component) <1 No Biopsy 
Hope you found this blog helpful for your NEET SS Surgery Breast and endocrine preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.

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