Liquid chromatography-tandem mass spectrometry - Application in the clinical laboratory

This review provides a concise survey of liquid chromatography
tandem mass spectrometry (LCTMS) as an emerging technology in
clinical chemistry. The combination of two mass spectrometers with
an interposed collision cell characterizes LCTMS as an analytical
technology on its own and not just as a more specific detector for
HPLC compared with conventional techniques. In LCTMS, liquid
chromatography is rather used for sample preparation but not for
complete resolution of compounds of interest. The instrument
technology of LCTMS is complex and comparatively expensive;
however, in routine use, methods are far more rugged compared to
conventional chromatographic techniques and enable highthroughput
analyses with very limited manual handling steps. Moreover,
compared to both gas chromatographymass spectrometry (GCMS) and
conventional HPLC techniques, LCTMS is substantially more versatile
with respect to the spectrum of analyzable compounds. For these
reasons it is likely that LCTMS will gain far more widespread use
in the clinical laboratory than HPLC and GCMS ever did. In this
article, the key features of LCTMS are described, method
development is explained, typical fields of application are
discussed, and personal experiences are related.