HPLC-high resolution mass spectrometry in clinical laboratory?

To date, GC-MS and LC-tandem MS techniques emerged quite frequently in laboratory medicine. However, high-resolution mass spectrometric (HRMS) analyzers remain almost ignored, even though in academic environment, they become more largely used. The main objective of this work is to present and illustrate with several applications, current high resolution mass spectrometric systems which could be useful for clinical applications. Among these systems are the Time-of-Flight (TOF) and Orbitrap instruments. Orbitrap has the advantage of higher resolution but suffers from a slower data acquisition, whereas TOF systems display the opposite characteristics. Both systems could provide accurate mass data and possible structural elucidation, very useful in large scale screening, in different medical areas (clinical or environmental toxicology, anti-doping controls, ...). Provided there are further improvements in quantification performances, there is no doubt such HRMS instruments will find their place in clinical laboratories. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.