“If you have visions, you should go to the doctor” – at least according to former German Chancellor Helmut Schmidt, who is said to have uttered these trenchant words. In laboratory medicine, you could rephrase this saying and say that visionaries should go to the medical laboratory. Not, mind you, to be cured of their vision, but on the contrary, to see the great benefits that mass spectrometry can bring to patient care. However, currently only in laboratories that can cope with the high manual workload and have the right specialists available.

Roche Diagnostics Deutschland GmbH therefore once again dedicated its lunch symposium at this year’s Congress for Laboratory Medicine (DKLM) in Bremen to mass spectrometry. Professor Michael Vogeser from Ludwig-Maximilians-Universität (LMU) spoke about the potential of mass spectrometry in clinical laboratories, but also about its limitations – and ways of overcoming them. He explained the many steps involved in the procedure in detail and emphasized the great importance of sample preparation for the high specificity and sensitivity of mass spectrometry. A handful of methods are currently available for this purpose.

Gamechanger magnetic particle extraction

The centerpiece of his presentation was sample preparation using the innovative extraction technique with paramagnetic particles with defined surfaces. This makes it possible to parallelize work steps and achieve throughputs and speeds that would be impossible with conventional sample preparation techniques. Michael Vogeser emphasized: “This is the fundamental technical advance that magnetic particle extraction brings.” The ability to process individual samples with dedicated paramagnetic particle workflows allows work to be carried out in random access instead of in batches, as was previously the case. Vogeser is convinced: “Magnetic particle extraction is what you call a game changer for mass spectrometry in clinical laboratories – with all its advantages, especially for time-critical intensive care medicine that relies on accuracy.”

Dr. Tobias Franz from Roche Diagnostics GmbH demonstrated the added value that mass spectrometry can bring to the clinical laboratory, for example in determining drug levels, in hormone diagnostics, in drug testing or in special applications such as newborn screening. Another advantage of the highly reliable method, which measures the analyte directly, is the simultaneous measurement of substances and their metabolites. Matrix effects, interference and cross-reactivity are also significantly reduced compared to other technologies.

From vision to reality

Despite its undisputed advantages, mass spectrometry has not yet become widely used. This is mainly due to the lack of automation, which makes implementation in the laboratory more difficult, especially in times of increasingly scarce resources, a growing shortage of skilled workers and rising test volumes – while maintaining the same high quality standards. Roche is therefore working intensively on the Roche Mass Spec project, which was launched in 2014, to develop a fully automated system with high throughput and fast TAT that enables seamless integration into clinical chemistry and immunology as well as into the associated IT environment: the future cobas® Mass Spec solution. “Together with our customers, we have drawn a picture, a vision of what a mass spectrometry solution must look like in order to be implemented in routine practice,” says Tobias Franz. The innovative sample preparation of the cobas® Mass Spec System using magnetic particle extraction makes it possible to work in random access. In addition, the system design not only integrates sample preparation, chromatography and detection unit, but also data analysis and evaluation. He emphasizes: “With our unique design, the vision of integrating mass spectrometry into the routine of the central laboratory has become a realistic goal! We are excited to bring our solution to the market in the coming months.”

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