From targeted quantification to untargeted metabolomics: Why LC-high-resolution-MS will become a key instrument in clinical labs

Most late model high-resolution mass spectrometers (HRMS) are capable of performing sensitive and reliable quantifications of a large variety of analytes in global HR-full scan (HR-FS) or, if needed, in a more targeted SIM or MS2 mode. Usual LC-HRMS analysis records HR-FS that gives a global picture of a sample extract as virtually all ionized compounds are detected. This is more and more seen as a key advantage. The use of one MS platform from targeted quantification to untargeted metabolomics will streamline workflows in the clinical environment and should allow projects to be more easily undertaken and realized. After 1) setting the basis in quantitative LC-HRMS analysis, we will give concrete examples revealing 2) quantitative, 3) qualitative, 4) simultaneous Quan/Qual and 5) omics capabilities of HRMS in an integrated context of routine analyses and clinical research. In the light of the new HRMS-based paradigm, further analyses will be discussed.