Mass Spectrometry Past and Present - Emerging Technologies and Strategies for Quality Management in Today's Clinical Laboratory

 

Mass Spectrometry (MS) has been an invaluable tool for physicists and basic chemists for over 100 years. It was not until around 30 to 40 years ago that technological advancements in ionization and sample preparation allowed for clinical applications to flourish. In the clinical lab, MS technology have mostly been limited to large reference laboratories due to instrument cost and complexity, but this is rapidly changing as advancements in user-friendly software, commercially available kit methods and simplified workflows become available. Services such as high resolution MS for toxicology, matrix-assisted laser desorption ionization (MALDI) MS for bacterial identification, and triple quadrupole MS for therapeutic drug monitoring and endocrinology applications have become more common in recent years, and with imminent expansion to the fields of anatomic pathology, hematology, and point of care, it is more important than ever for laboratory staff and leadership to have a fundamental understanding of MS, relevant quality metrics, and troubleshooting strategies. This presentation will provide a historical perspective on MS in the clinical lab, discuss some of the technologies currently available and provide insight on advances in automation, sample preparation and LIS interfacing. Additionally, we will review some real-world applications of MS with focus on accreditation and quality metric monitoring (e.g. system suitability samples, QC and calibrator preparation, lot-to-lot validations, and hydrolysis efficiency). We will cover some common troubleshooting scenarios such as a sudden losses of instrument sensitivity, chromatography performance degradation, ion suppression, and inconsistent internal standard recovery. Specific case studies will be covered to give examples of where MS applications provide superior performance to other assays, including detection and quantification of M-proteins in multiple myeloma, hormones, and therapeutic drugs.

 

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