For many intraoperative decisions surgeons depend on frozen section pathology, a technique developed over 150 y ago. Technical innovations that permit rapid molecular characterization of tissue samples at the time of surgery are needed. Here, using desorption electrospray ionization (DESI) MS, we rapidly detect the tumor metabolite 2-hydroxyglutarate (2-HG) from tissue sections of surgically resected gliomas, under ambient conditions and without complex or time-consuming preparation. With DESI MS, we identify isocitrate dehydrogenase 1-mutant tumors with both high sensitivity and specificity within minutes, immediately providing critical diagnostic, prognostic, and predictive information. Imaging tissue sections with DESI MS shows that the 2-HG signal overlaps with areas of tumor and that 2-HG levels correlate with tumor content, thereby indicating tumor margins. Mapping the 2-HG signal onto 3D MRI reconstructions of tumors allows the integration of molecular and radiologic information for enhanced clinical decision making. We also validate the methodology and its deployment in the operating room: We have installed a mass spectrometer in our Advanced Multimodality Image Guided Operating (AMIGO) suite and demonstrate the molecular analysis of surgical tissue during brain surgery. This work indicates that metabolite-imaging MS could transform many aspects of surgical care.T he microscopic review of tissue biopsies frequently remains the sole source of intraoperative diagnostic information, and many important surgical decisions such as the extent of tumor resection are based on this information. This approach is timeconsuming, requiring nearly 30 min between the moment a tissue is biopsied and the time the pathologist's interpretation is communicated back to the surgeon. Even after the report of the final pathologic diagnosis is issued days later, a lot of diagnostic, prognostic, and predictive information is left undiscovered and unexamined within the tissue. Tools that provide more immediate feedback to the surgeon and the pathologist and that also rapidly extract detailed molecular information could transform the management of care for cancer patients.MS offers the possibility for the in-depth analysis of the proteins and lipids that comprise tissues (1, 2). We have recently shown that desorption electrospray ionization (DESI) MS is a powerful methodology for characterizing lipids within tumor specimens (3-6). The intensity profile of lipids ionized from within tumors can be used for classifying tumors and for providing valuable prognostic information such as tumor subtype and grade. Because DESI MS is performed in ambient conditions with minimal pretreatment of the samples (7,8), there is the potential to provide diagnostic information rapidly within the operating room (4, 6, 9). The ability to quickly acquire such valuable diagnostic information from lipids prompted us to determine whether we could use DESI MS to detect additional molecules of diagnostic value within tumors, such as their metabolites.Recently,...

The development of ambient desorption/ionization mass spectrometry has shown promising applicability for the direct analysis of complex samples in the open, ambient atmosphere. Although numerous plasma-based ambient desorption/ionization sources have been described in the literature, little research has been presented on experimentally validating or determining the desorption and ionization mechanisms that are responsible for their performance. In the present study, established spectrochemical and plasma physics diagnostics in combination with spatially resolved optical emission profiles were applied to reveal a set of reaction mechanisms responsible for afterglow and reagent-ion formation of the Low-Temperature Plasma (LTP) probe, which is a plasma-based ionization source used in the field of ambient mass spectrometry. Within the dielectric-barrier discharge of the LTP probe, He(2)(+) is the dominant positive ion when helium is used as the plasma supporting gas. This helium dimer ion (He(2)(+)) has two important roles: First, it serves to carry energy from the discharge into the afterglow region in the open atmosphere. Second, charge transfer between He(2)(+) and atmospheric nitrogen appears to be the primary mechanism in the sampling region for the formation of N(2)(+), which is an important reagent ion as well as the key reaction intermediate for the formation of other reagent ions, such as protonated water clusters, in plasma-based ambient ionization sources. In the afterglow region of the LTP, where the sample is usually placed, a strong mismatch in the rotational temperatures of N(2)(+) (B (2)Σ(u)(+)) and OH (A (2)Σ(+)) was found; the OH rotational temperature was statistically identical to the ambient gas temperature (~300 K) whereas the N(2)(+) temperature was found to rise to 550 K toward the tail of the afterglow region. This much higher N(2)(+) temperature is due to a charge-transfer reaction between He(2)(+) and N(2), which is known to produce rotationally hot N(2)(+) (B (2)Σ(u)(+)) ions. Furthermore, it was found that one origin of excited atomic helium in the afterglow region of the LTP is from dielectronic recombination of vibrationally excited He(2)(+) ions.

The advent of ambient desorption/ionization mass spectrometry has resulted in a strong interest in ionization sources that are capable of direct analyte sampling and ionization. One source that has enjoyed increasing interest is the Flowing Atmospheric-Pressure Afterglow (FAPA). FAPA has been proven capable of directly desorbing/ionizing samples in any phase (solid, liquid, or gas) and with impressive limits of detection (<100 fmol). The FAPA was also shown to be less affected by competitive-ionization matrix effects than other plasma-based sources. However, the original FAPA design exhibited substantial background levels, cluttered background spectra in the negative-ion mode, and significant oxidation of aromatic analytes, which ultimately compromised analyte identification and quantification. In the present study, a change in the FAPA configuration from a pin-to-plate to a pin-to-capillary geometry was found to vastly improve performance. Background signals in positive- and negative-ionization modes were reduced by 89% and 99%, respectively. Additionally, the capillary anode strongly reduced the amount of atomic oxygen that could cause oxidation of analytes. Temperatures of the gas stream that interacts with the sample, which heavily influences desorption capabilities, were compared between the two sources by means of IR thermography. The performance of the new FAPA configuration is evaluated through the determination of a variety of compounds in positive- and negative-ion mode, including agrochemicals and explosives. A detection limit of 4 amol was found for the direct determination of the agrochemical ametryn, and appears to be spectrometer-limited. The ability to quickly screen for analytes in bulk liquid samples with the pin-to-capillary FAPA is also shown.

Two relatively new ambient ionization sources, direct analysis in real time (DART) and the flowing atmospheric-pressure afterglow (FAPA), use direct current, atmospheric-pressure discharges to produce reagent ions for the direct ionization of a sample. Although at a first glance these two sources appear similar, a fundamental study reveals otherwise. Specifically, DART was found to operate with a corona-to-glow transition (C-G) discharge whereas the FAPA was found to operate with a glow-to-arc transition (G-A) discharge. The characteristics of both discharges were evaluated on the basis of four factors: reagent-ion production, response to a model analyte (ferrocene), infrared (IR) thermography of the gas used for desorption and ionization, and spatial emission characteristics. The G-A discharge produced a greater abundance and a wider variety of reagent ions than the C-G discharge. In addition, the discharges yielded different adducts and signal strengths for ferrocene. It was also found that the gas exiting the discharge chamber reached a maximum of 235°C and 55°C for the G-A and C-G discharges, respectively. Finally, spatially resolved emission maps of both discharges showed clear differences for N 2 ϩ and O(I). These findings demonstrate that the discharges used by FAPA and DART are fundamentally different and should have different optimal applications for ambient desorption/ionization mass spectrometry (ADI-MS). irect-current (DC) discharges have been widely used for elemental analyses since they were first introduced for alloy characterization [1]. When DC discharges were coupled with mass spectrometry, the result was a very sensitive and powerful tool for elemental [1] and molecular analyses [2,3]. Of the many electrical regimes of DC discharges, three forms have been found to have particular analytical merit: the arc, the glow, and the corona. Among these three types of discharges, the fundamental distinction is the operating current and voltage. The arc occurs at very high currents (hundreds of amperes) with a low voltage drop between electrodes (tens of volts). It also exhibits negative resistance; that is, the sustaining voltage drops as the current rises. The glow discharge (GD), which has conventionally been operated between 0.1 to 10 Torr, exists at much lower currents (tens of milliamperes) and a higher voltage drop (hundreds of volts). Lastly, the corona discharge operates with very low currents (a few microamperes) and a much higher voltage drop (several kilovolts).Corona discharges find their most common analytical application in atmospheric pressure chemical ionization (APCI) [4,5]. In conventional APCI, a corona discharge is formed by applying ϳ4 kV to a needle electrode in a selected atmosphere, to yield currents of ϳ5 A. After a series of reactions [5], reagent ions are produced that can then ionize a sample. Protonated water clusters are typically observed because of the presence of water vapor in the air. Such protonated clusters promote proton transfer ionization, resulting in mass spect...

Low temperature plasma (LTP) ionization is an ambient plasma ionization method that permits the direct mass analysis of samples in their native atmospheric environment with little or no sample preparation. In this work, the low temperature plasma probe is used in the direct and rapid mass spectrometric analysis of aqueous phase samples including biofluids (saliva, urine, and hair extract). A detailed trace qualitative examination of 14 drugs of abuse has been performed. The relative standard deviation on average was approximately 16% for the LTP analysis of the drugs of abuse standards. Eleven of the fourteen drugs of abuse were detected in the low ng mL(-1) (3 pg absolute detection) to the mid microg mL(-1) (approximately 30 ng absolute detection) concentration range. One drug, cannabidiol, could not be detected until supplemental heating of the substrate was incorporated into the experimental protocol. The addition of supplemental heating improved the detection limits by at least an order of magnitude to approximately 0.5 ng mL(-1) to 0.5 microg mL(-1) (1.5 pg-1.5 ng absolute) for twelve of the fourteen drugs of abuse, so extending the linear dynamic range which for most analytes was four orders of magnitude. Quantitative capabilities were evaluated using the particular example of benzoylecgonine in urine by employing a deuterated internal standard. Matrix effects observed during the analysis of the drugs in complex biological fluids are also discussed. In addition, low temperature plasma ionization was applied to the examination of real (not spiked) biological samples and these results were confirmed using standard LC/MS methodology. The main advantages observed for this ambient desorption/ionization technique include the capabilities for direct analysis of liquid surfaces for in situ detection and the remarkable sensitivity in the examination of the drugs of abuse investigated here. The disadvantages of the method include the modest quantitative accuracy making LTP most useful as a rapid but semi-quantitative screening method.