title: Serum PSA adjusted for volume of transition zone (PSAT) is more accurate than PSA adjusted for total gland volume (PSAD) in detecting adenocarcinoma of the prostate.
abstract: OBJECTIVE
  This study evaluates the accuracy of comparing serum prostate-specific (PSA) levels in the range between 4.1 ng/mL and 10.0 ng/mL (monoclonal) to the volume of the transition zone (TZ) of the prostate and total gland volume as a predictor of a positive biopsy.
  
  
  METHODS
  Using sonographic voluming of the entire prostate and of the TZ, prostate-specific antigen density (PSAD) and prostate-specific antigen density of the TZ (PSAT) were calculated in 21 biopsy-positive patients and 38 biopsy-negative patients. Biopsy was directed at sonographically suspicious areas and did not include sextant biopsies.
  
  
  RESULTS
  A statistically significant association was determined between a positive biopsy and gland volume, TZ volume, and PSAT. The association of a positive biopsy with PSA and PSAD was not statistically significant.
  
  
  CONCLUSIONS
  PSAT is more accurate in predicting a positive biopsy than is PSAD for PSA levels between 4.1 ng/mL and 10.0 ng/mL.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: J
authors.initials: J
authors.lastname: Kalish
authors.forename: W H
authors.initials: WH
authors.lastname: Cooner
authors.forename: S D
authors.initials: SD
authors.lastname: Graham
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000175:diagnosis; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen