Applications of mass spectrometry in the routine diagnostic medical laboratory – a status report 2025

Mass spectrometry methods have become an essential part of the methodological portfolio of laboratory medicine over the past three decades. At present, however, their application is still largely limited to highly specialized laboratories in relatively few countries. Nevertheless, the technology provides important impulses for laboratory diagnostics overall—for example, in clinical pharmacology through innovative applications in therapeutic drug monitoring and precision dosing. After relatively slow progress in the area of automation, the first fully automated, closed MS-based analytical systems have recently been introduced for routine medical laboratories. In terms of usability, these systems are comparable to standard platforms based on photometry or ligand-binding techniques. The aim of this article is to describe the current medical, analytical, and organizational aspects of MS applications in diagnostics. • Mass spectrometry has taken on a limited but growing role in diagnostic medicine. • MS enables innovative procedures, e.g. in therapeutic drug monitoring for precise dosing. • Fully automated MS systems for routine use in medical laboratories are on the rise.