Objective:

To establish normative reference values for PSA, MRI-derived prostate volume (PV), and PSA density (PSAD) among men in a population-based cohort without reported prostate disease.

Approach:

• Study Design: Data were drawn from the Study of Health in Pomerania (SHIP), a government-funded, population-based study in Northeast Germany, involving clinical assessments, laboratory testing, and whole-body MRI.
• Cohort Selection: Participants aged 20–79 years were randomly invited, with exclusions for known prostate diseases, ensuring a healthy baseline cohort.
• MRI Methodology: Pelvic MRI was performed using a 1.5-T Siemens MAGNETOM Avanto scanner, with prostate volumes obtained from automated whole-gland segmentations using a deep learning model.

Key Findings:

• Reference values for PSA, PV, and PSAD were established for healthy males.
• MRI-derived PV measurements were found to be more accurate compared to traditional TRUS methods.
• Age, height, BMI, and PSA levels were identified as potential non-pathological confounders.

Interpretation:

The reference values provide context for interpreting PSA, prostate volume, and PSA density in men without reported prostate disease. Because these measures may vary with age and other individual characteristics, those factors should be considered when assessing results.

Limitations:

• The study's cohort was limited to a specific geographic region in Germany.
• Exclusions based on prior prostate conditions may limit generalizability.

Conclusion:

This population-based study provides MRI-derived reference values for PSA, prostate volume, and PSA density in healthy men from Northeast Germany. Further validation in other populations may be needed before applying these values more broadly.