Schneider AF, Stocker D, Hötker AM, et al. - In this single-center, retrospective cohort study of men who underwent MRI of the prostate in 2015 and 2016 who had a transperineal template saturation biopsy within 6 months of MRI (n = 178), experts contrasted the relationship of transition zone prostate-specific antigen density (TZPSAD) vs whole gland (WG) density (PSAD) with Gleason score. Compared with PSAD, the TZPSAD showed a more robust association with cancer dedifferentiation and it could, hence, be a superior surrogate marker for cancer aggressiveness than PSAD. Furthermore, of men with suspected prostate cancer, the TZPSAD threshold of 0.22 ng/ml² may aid in the risk lamination.