Evaluation of the Abbott IMx automated immunoassay of prostate-specific antigen

We detail the performance characteristics of the new IMx PSA immunoassay developed by Abbott Laboratories, addressing PSA recovery, assay reproducibility, standard curve storage, lower limit of detection, dilution linearity, and correlation with the Hybritech Tandem-R PSA immunoassay. We analyzed 686 sera for PSA retrospectively, testing 555 of these concurrently with the IMx and the Tandem-R immunoassays. The IMx PSA standard curve was linear from 0 to 100 micrograms/L, and curve storage was maintained for 4 weeks. The lower limit of detection of the IMx PSA assay was < or = 0.03 microgram/L; allowing for the assay precision yielded a biological detection limit of 0.06 microgram/L. We conservatively set the clinical threshold at 0.1 microgram/L. Regression analysis of dilution linearity involving 10 samples (0.44-200 micrograms/L) resulted in coefficients of correlation ranging from 0.9972 to 1.000. Reproducibility studies with 18 specimens within the range of 0.39-413.67 micrograms/L gave intra- and interassay CVs < 6.5%. The interassay 95% confidence interval for a specimen containing 0.06 microgram of PSA per liter was 0.03-0.09 microgram/L. Correlation between IMx and Tandem-R PSA assay results was excellent: r = 0.9909 and slope = 0.95. Overall, the IMx PSA immunoassay, with the conveniencies of automation, curve storage, and nonisotopic handling, provided an improved lower limit of PSA detection, which allows for earlier indication of residual or recurrent disease after radical prostatectomy.