= Emerging. More than 5 years before clinical availability. (19.79%, 2022)
= Expected to be clinically available in 1 to 4 years. (37.97%, 2022)
= Clinically available now. (42.25%, 2022)
MSACL 2022 : Choucair

MSACL 2022 Abstract

Self-Classified Topic Area(s): Emerging Technologies > Tox / TDM / Endocrine > Assays Leveraging MS

Podium Presentation in De Anza 1 on Wednesday at 15:55 (Chair: Vishnu Samara)

Rapid Urine Drug Testing by Direct Analysis in Real-Time (DART)-Mass Spectrometry

Ibrahim Choucair (1), Gina Cassella-Mclane (1), Joe El-Khoury (1)
(1) Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT

Ibrahim Choucair, PhD (Presenter)
Yale School of Medicine

Presenter Bio: My career in clinical chemistry started with a B.S. in Clinical Laboratory Science and a
Master degree in Bioanalytical Toxicology.
I worked in an analytical reference lab for 6 years. My job responsibilities included, but were not limited to, the development and/or optimization of new analytical tests, training students and professionals and overseeing the management and quality assurance of the laboratory. I helped develop analytical methods using various chromatography and mass spectrometry technologies for extended inborn errors of metabolism screening, therapeutic drug monitoring, amino acids analysis and many more.
In 2019, I obtained my PhD degree in Clinical Bioanalytical Chemistry (Clinical
Chemistry ComaACC-accredited track) from the joint program of the Department of Chemistry,
Cleveland State University and the Department of Cardiovascular and Metabolic Sciences,
Lerner Research Institute, Cleveland Clinic. The focus of my research was to study the relationship between gut microbe metabolism of bile acids and cardiometabolic diseases. Within my PhD project I developed and fully validated a multiplex liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the quantification of 60 bile acids, and used it to study the association of bile acids in human plasma and chronic diseases, like type 2 diabetes and cardiovascular disease. Moreover, I participated in several metabolomics and proteomics side projects using different Mass Spectrometry platforms.
Today I am a clinical chemistry fellow at Yale-New Haven Health, where I am developing a state of the art direct analysis in real time (DART) tandem mass spectrometry (MS/MS) method for the rapid analysis of drugs in urine clinical samples.


Since 1999, over 750,000 people in the U.S. have died from a drug overdose involving an opioid. What’s more concerning is the recent trend showing an increase in synthetic opioid-related deaths, with the U.S. Centers for Disease Control and Prevention (CDC) reporting a 10 to 53% increases year-over-year since 2017. This dramatic increase is largely being driven by the rise of stimulant (like methamphetamine and cocaine) and synthetic opioid co-use, in what the experts are now calling the “fourth wave” of the opioid epidemic. Fentanyl and analogues are largely responsible for this recent upward tick in drug-related deaths in the U.S., and this issue is quickly becoming a global crisis. Current clinical laboratory technologies are not adapting quickly enough to the evolving landscape of drug use, with immunoassays for fentanyl and synthetic analogues taking too long to develop, and liquid chromatography-tandem mass spectrometry methods not widely available and often taking days to result due to their complexity.

Direct analysis in real time (DART) tandem mass spectrometry (MS/MS). DART is a cutting-edge ionization technology that requires no sample preparation and no chromatography. While DART is currently used in several applications like food chemistry, it has not been validated for a clinical laboratory application.

Results and Discussion
We have developed a fast DART-MS/MS method for the qualitative analysis of 15 opioids in less than 10 seconds, the method’s limit of detection for all compounds is below 10ng/ml in pure standards. The DART temperature was optimized to 250˚C with sample scan speed of 1mm/s. The new method promises to cut turnaround time from days to minutes, and with the high sensitivity and specificity of mass spectrometry technology, we believe that it may one day replace or supplement immunoassays as a drug screening tool.

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