MSACL Conference Schedule

Mass Spectrometry Can Improve Clinical Chemistry and Patient Care
Mon 8:10 AM - Plenary Session
Jack Henion
This presentation will present an overview the merits and issues pertaining to implementing mass spectrometry and in particular, LC/MS techniques, into the modern clinical laboratory. The strengths and limitations of mass spectrometry including a summary of the relevant key components of a mass spectrometer system will be described with a strong emphasis for the value provided by employing LC/MS for potentially screening a wide variety of diseases and clinical tests which have historically employed immunoassay techniques (RIA, ELISA, etc.). In addition to the established, very successful qualitative and quantitative aspects of LC/MS/MS, example applications will be overviewed as potential new strategies that could combine reduced sample preparation as well as rapid analyses using mass spectrometry. Examples to be shown will demonstrate how LC/MS provided a definitive analytical 'edge' for solving a clinical and toxicological problem. Examples include testosterone and Vitamin D tests which are slow immunological tests requiring high consumable costs and sometimes inconclusive results whereas LC/MS has minimal consumable costs along with high sensitivity and specificity. The huge success of newborn screening will be described where FIA/MS/MS routinely screens for a panel of acyl carnitines for thousands of newborn infants each year. An introduction to SRM LC/MS determination for plasma proteins will be described as the next potential wave of clinical applications for MS.

A glimpse of the future will include rapid microsynthesis of unique radioactive isotope-incorporated compounds QC'd by LC/MS for the purpose of PET imaging of cancers and related diseases. Chip-based nanoelectrospray MS will also be presented as an approach for the rapid automated analysis of appropriately cleaned up biological samples in clinical applications ranging from newborn screening to the determination of immunosuppressants in biological samples. The merits of ion mobility spectrometry coupled with TOF MS will also be overviewed as a system with an added dimension of orthogonal separation via the Waters SYNAPT system. Each of these examples will be presented as a primer to the analytical potential of mass spectrometry for the clinical laboratory of medicine of the future.

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