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Published on: January 20, 2022
After another decade: LC-MS/MS became routine in clinical diagnostics
Christoph Seger1, Linda Salzmann1
1Labormedizinisches Zentrum Dr Risch, Lagerstrasse 30, 9470 Buchs, SG, Switzerland; Institute of Pharmacy, Department of Pharmacognosy, CCB - Centrum of Chemistry and Biomedicine, CMBI - Center for Molecular Biosciences, University of Innsbruck, Innrain 80-82, 9020 Innsbruck, Austria.
Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a vital diagnostic tool in laboratory medicine, offering irreplaceable technology for various applications. Future directions include protein quantification and omics approaches for diagnostics.
Area of Science:
- Clinical Chemistry
- Analytical Chemistry
- Mass Spectrometry
Background:
- Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a cornerstone technology in modern laboratory medicine.
- Its routine use is well-established and often surpasses alternative diagnostic methods.
- The past decade (2009-2019) has seen significant advancements in instrumentation and application.
Purpose of the Study:
- To provide an overview of the developments in LC-MS/MS in laboratory medicine from 2009-2019.
- To offer insights into the current status and future trajectory of LC-MS/MS applications.
- To highlight the role of the in vitro diagnostics (IVD) industry in market development.
Main Methods:
- Review of advancements in LC-MS/MS instrumentation and technology over the past decade.
- Analysis of current routine applications in therapeutic drug monitoring, endocrinology, and toxicology.
- Discussion of emerging trends and challenges in LC-MS/MS diagnostics.
Main Results:
- Significant maturation of LC-MS/MS instrumentation and well-understood applications.
- The IVD industry is actively shaping the market with assay kits and automated systems.
- Despite advancements, LC-MS/MS implementation can be complex, requiring specialized staff and lab-developed tests (LDTs).
Conclusions:
- LC-MS/MS is indispensable in current diagnostic niches like therapeutic drug monitoring, newborn screening, and toxicology.
- Future challenges include protein quantification and the shift towards untargeted omics for diagnostic decision-making.
- Pattern recognition in omics data is key for future diagnostic advancements using LC-MS/MS.
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