ARRS 2022 Abstracts

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E1729. More to TI-RADS Than Meets the Eye: Evaluation of Echogenic Foci for the First Year Radiology Resident
Authors
  1. Colin O'Connor; SUNY Downstate Health Sciences University
Background
As a new trainee in the field of radiology, it may come as a surprise that the assessment process in many modalities is quite subjective. The subspecialty of ultrasound with its dependence on a sonographer’s skills is a belabored fact in medical education. The inter-user variability is not limited to the sonographers, however. How radiologists describe nodules, specifically internal echogenic foci, is an important step in TI-RADS scoring. Our ordering clinicians expect a consistent evaluation of the characteristics of thyroid nodules. This can make a seemingly straightforward scoring process present challenges, especially for the first year radiology resident.

Educational Goals / Teaching Points
This exhibit aims to identify echogenic foci of the thyroid nodule; characterize echogenic foci, with special attention to what distinguishes benign, less benign, and concerning lesions; and provide a consistent score for the evaluation of echogenic foci using the TI-RADS system.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit includes ultrasound evaluation of precipitated colloid, psammomatous colloid, macrocalcifications, inspissated colloid, punctate calcifications, acoustic shadowing, comet-tail calcifications, dystrophic calcifications, and peripheral calcifications.

Conclusion
As a first year radiology resident, being aware of the multitude of echogenic foci is an important component of thyroid nodule assessment. The ability to accurately characterize these foci can be achieved with experience.