Impact of LC-MS/MS on the laboratory diagnosis of catecholamine-producing tumors

Applications of LC-MS/MS for the biochemical diagnosis of catecholamine-producing tumors have followed from parallel emergence of this technology with changes in emphasis of biochemical testing, in particular requirements that testing include measurements of plasma or urinary fractionated metanephrines. Since the turn of the century, when LC-MS/MS was first introduced into the routine laboratory, there have been numerous advances in analytical methodology that offer opportunities for breaking away from out-moded analytical procedures to methods that provide enhanced diagnostic information with dramatically improved analytical sensitivity, accuracy and precision as well as rapid sample throughput. LC-MS/MS also offers high analytical specificity, but is not infallible. Multiple reaction monitoring does not always guarantee selectivity and attention to sample purification and chromatographic separation remains important. Although other analytical methods persist, today LC-MS/MS represents the method of choice for high-throughput, low-cost, precise and accurate measurements of the catecholamine metabolites now routinely used for diagnosis of catecholamine-producing tumors.