Portable mass spectrometry systems for point-of-care testing: technologies, applications, and clinical implementation.

Portable mass spectrometry systems have shown great potential in point-of-care testing and field-based diagnostics, as they fill important gaps in decentralized clinical analysis. Conventional centralized laboratory testing may delay clinical decision making due to transport and analysis times. For conditions where transportation is limited, these delays disproportionately affect resource-poor settings. Advances in technology allow the design and assembly of lightweight, portable MS systems. Fundamental issues such as size reduction, power consumption, and vacuum requirements have been addressed as the MS miniaturization field has developed. These advances have generated commercially available devices and home-built instruments capable of rapid analysis, often without extensive sample preparation. Studies on applicability of portable MS have already shown utility in multiple fronts, such as therapeutic drug monitoring for HIV, psychiatric drugs, and cardiac interventions; drug profiling in forensic medicine; disease diagnosis including malaria detection; and cancer tissue analysis. Nevertheless, the tradeoff between miniaturization and sensitivity, small mass resolution relative to benchtop instruments, and challenges in reproducibility represent ongoing issues with miniaturized mass spectrometry. Despite these disadvantages, significant clinical potential can be concluded from current published evidence. With the development of complementary sample preparation methods and miniaturization technology, portable MS systems could see implementation in emergency departments, mobile clinics, and resource scarce clinic environments.