LC-MS/MS Matures into Routine Clinical Diagnostics After a Decade of Growth
This overview documents the maturation of LC-MS/MS from a specialized research tool to an established routine platform in clinical laboratories over the 2009-2019 decade. The technology is now indispensable for therapeutic drug monitoring, endocrinology including newborn screening, and toxicology. The transition from lab-developed tests to IVD-certified kits and automated LC-MS/MS instruments marks a turning point, though protein quantification and untargeted omics-based diagnostic approaches remain frontier challenges.
The original study
After another decade: LC-MS/MS became routine in clinical diagnostics.
- Authors
- Seger C, Salzmann L
- Journal
- Clinical biochemistry
- Type
- Journal Article, Review
- PMID
- 32188572
Original abstract
Tandem mass spectrometry - especially in combination with liquid chromatography (LC-MS/MS) - is applied in a multitude of important diagnostic niches of laboratory medicine. It is unquestioned in its routine use and is often unreplaceable by alternative technologies. This overview illustrates the development in the past decade (2009-2019) and intends to provide insight into the current standing and future directions of the field. The instrumentation matured significantly, the applications are well understood, and the in vitro diagnostics (IVD) industry is shaping the market by providing assay kits, certified instruments, and the first laboratory automated LC-MS/MS instruments as an analytical core. In many settings the application of LC-MS/MS is still burdensome with locally lab developed test (LDT) designs relying on highly specialized staff. The current routine applications cover a wide range of analytes in therapeutic drug monitoring, endocrinology including newborn screening, and toxicology. The tasks that remain to be mastered are, for example, the quantification of proteins by means of LC-MS/MS and the transition from targeted to untargeted omics approaches relying on pattern recognition/pattern discrimination as a key technology for the establishment of diagnostic decisions.