High resolution accurate mass (HRAM) mass spectrometry

Over the past decade, mass spectrometry has grown from a primary use as an analytical method relegated to research or industrial applications to a method routinely applied in clinical settings. The utilization of mass spectrometry in a clinical setting requires accurate and robust measurement of diverse sets of analytes from a variety of matrices. The adoption of mass spectrometry in the clinic has certainly been slow because in many cases, there are large-scale immunoassay analyzers that meet the clinical requirements and can provide thousands of results for several assays every day. In many cases, immunoassay-based platforms can be more sensitive than mass spectrometers, though in recent years this divide is closing and in some cases mass spectrometry has surpassed immunoassays in this respect. However, there is a greater likelihood of analytical interference in immunoassay-based analyzers than mass spectrometers. This has caused some professional societies, such as the Endocrine Society, to mandate that in the near future steroid hormone levels be generated from a mass spectrometry based analyzer for consideration for publication in the Society Journal. This mandate comes at a time when the mass spectrometer has started to see considerable adoption in several clinical fields: small molecule analysis (e.g., toxicology), microbial identification, and molecular diagnostics. However, these fields may have not realized the clinical utility of mass spectrometry if not for the advent of high resolution mass spectrometry (HRMS).