As the workload increased, the laboratory introduced bar code recognition and an interface into the Laboratory Information Management System (LIMS) in 2013
Shutterstock/Juergen Faelchle

Automation

Mass spectrometry is advancing laboratory practice

Mass spectrometry is moving laboratory medicine to increasingly automated discrete analysis methods, resulting in ever faster and more reliable results.

Report: Mark Nicholls

It is also leveraging economies of scale as an increasingly cost-effective tool, says Craig Webster, Consultant Clinical Scientist and Clinical Lead, Department of Biochemistry and Immunology at Heartlands Hospital in Birmingham. Speaking about ‘Advances in Mass Spectrometry – future diagnostic uses’ during FiLM 2018 – Frontiers in Laboratory Medicine congress this January, Webster outlined how mass spectrometry  is being automated for common analytes and how this may change laboratory medicine practice.

Advances in mass spectrometry and lab automation began growth in the mid-1990s and although some issues still include lack of sensitivity, cost, the highly specialist nature of the technique, ion suppression, sample variation, and some concern over standardisation of assays, he confirmed that mass spectrometry had emerged as the gold standard method for analytes. However, he added: ‘Because you have a fixed cost in the equipment you get better investment leverage from the technology if you put a massive workload through; you then get the benefits from the investment.’

From 20 samples a week to 65,000 per year – and more

However, there are difficulties in method optimisation and troubleshooting and the extra clinical information can often lead to over-investigation of patients.

Craig Webster

Webster, a consultant clinical biochemist for more than a decade, outlined the evolving use of mass spectrometry in Heartlands through the example and testing for Vitamin D deficiency, which started in his area 2006, and how that has moved forward in the last decade or so. With the initial technology his team examined 20 samples weekly, rising to 3,200 samples a year and then 4,500 in 2008, upgrading the Sciex API mass spectrometry system with a Tecan automated workflow solution and cutting the chromatography time from 10 minutes to two-and-a-half minutes. ‘Further workflow steps were automated with pipetting and removing of hexane, and online extraction meant we could take more costs out of the system,’ he said. ‘We had high quality extraction, achieved really clean samples, had good equipment, better uptime and less cleaning.’

By 2010 they handled 35,000 samples a year and 65,000 by 2013, introducing barcode recognition and an interface into the Laboratory Information Management System (LIMS) as the workload increase. Webster said his lab is at a stage where a medical laboratory technician could operate the system with minimal running costs, few sample rejections, and very few repeats. Cost per sample is now £3.10 with 95% done within 14 days. The team is moving towards multiplexing assays with mass spectrometry and simultaneously measuring multiple analytes in one run, but he also warned of disadvantages.

Photo
Dr Craig Webster is Consultant Clinical Scientist at Birmingham Heartlands Hospi­tal, the clinical lead for Bioche­mistry and Blood Sciences and is responsible for R&D in the department of Biochemistry and Immunology.

‘The advantages are that the sample only has to be prepared once; there’s faster turnaround time, combined calibration and controls and it offers extra clinical  information,’ Webster said. ‘However, there are difficulties in method optimisation and troubleshooting and the extra clinical information can often lead to over-investigation of patients.’ One more general issue is that the technological advances have exposed a lack of skills from informatics training. ‘It’s not just about putting a computer on the system; it’s about how that fits in with workflow and the people who work within that,’ Webster continued, adding: ‘More informatics training is important because without the IT we do not get full automation.’ With more trackable systems and electronic transfer of results, Webster said the system is now moving increasingly towards discrete analysers and an automated chemical analyser with the instrument performing tests on samples kept in discrete cuvettes in contrast to a continuous flow analyser. Mass spectrometry, he concluded, is now fully integrated into the LIMS and workflow at Heartlands, and needs less skilled staff, with an expansion into more analytes.


Profile:

Dr Craig Webster, Consultant Clinical Scientist at Birmingham Heartlands Hospi­tal, is the clinical lead for Bioche­mistry and Blood Sciences, responsible for R&D in the department of Biochemistry and Immunology. He has developed a number of projects utilising LC/MSMS. His technical background is wide-ranging, with major interests in HPLC, mass spectrometry, capillary electrophoresis and information technology.

05.03.2018

Read all latest stories

Related articles

Mass Spectrometry

Connected components are not enough

Bringing liquid chromatography and tandem mass spectrometry (LC-MS/MS) testing into clinical laboratories has been a slow process but continues to show promise to help improve patient care. The…

Mass spectrometry

‘Mass spectrometry has developed into a successful routine procedure,’ according to Dr Christoph Seger (Univ. Doz.), technical head of the Mass Spectrometry and Chromatography division at the…

Real walkaway automation

The all-in-one molecular laboratory system

The lab-in-the-box design of LabTurbo SP-qPCR All-in-one system offers true automation for the molecular laboratory, the manufacturer reports, adding that this ‘delivers testing confidence and…

Related products

Sample Processing

ASP Lab Automation - Bench-top Decapper Pluggo RH

ASP Lab Automation AG

Sample Processing

ASP Lab Automation - Tube Sorter SortPro

ASP Lab Automation AG

Sample Processing

Beckman Coulter - AutoMate 1250/2550

Beckman Coulter, Inc.

Automation

Beckman Coulter - Power Express

Beckman Coulter, Inc.