Report from the HarmoSter study: Inter-laboratory comparison of LC-MS/MS measurements of corticosterone, 11-deoxycortisol and cortisone

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Flaminia Fanelli - , University of Bologna (Author)
  • Stephen Bruce - , University of Lausanne (Author)
  • Marco Cantù - , Ente Ospedaliero Cantonale (Author)
  • Anastasia Temchenko - , University of Bologna (Author)
  • Marco Mezzullo - , University of Bologna (Author)
  • Johanna M. Lindner - , Ludwig Maximilian University of Munich (Author)
  • Mirko Peitzsch - , Institute of Clinical Chemistry and Laboratory Medicine, University Medicine (Faculty of Medicine and University Hospital), University Hospital Carl Gustav Carus Dresden (Author)
  • Pierre Alain Binz - , University of Lausanne (Author)
  • Mariette T. Ackermans - , Amsterdam University Medical Centers (UMC), University of Amsterdam (Author)
  • Annemieke C. Heijboer - , Amsterdam University Medical Centers (UMC), University of Amsterdam, Vrije Universiteit Amsterdam (VU) (Author)
  • Jody Van Den Ouweland - , Canisius Wilhelmina Hospital (Author)
  • Daniel Koeppl - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Elena Nardi - , University of Bologna (Author)
  • Manfred Rauh - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Michael Vogeser - , Ludwig Maximilian University of Munich (Author)
  • Graeme Eisenhofer - , Department of internal Medicine 3, Institute of Clinical Chemistry and Laboratory Medicine, University Medicine (Faculty of Medicine and University Hospital), University Hospital Carl Gustav Carus Dresden (Author)
  • Uberto Pagotto - , University of Bologna (Author)

Abstract

Objectives: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) panels that include glucocorticoid-related steroids are increasingly used to characterize and diagnose adrenal cortical diseases. Limited information is currently available about reproducibility of these measurements among laboratories. The aim of the study was to compare LC-MS/MS measurements of corticosterone, 11-deoxycortisol and cortisone at eight European centers and assess the performance after unification of calibration. Methods: Seventy-eight patient samples and commercial calibrators were measured twice by laboratory-specific procedures. Results were obtained according to in-house and external calibration. We evaluated intra-laboratory and inter-laboratory imprecision, regression and agreement against performance specifications derived from 11-deoxycortisol biological variation. Results: Intra-laboratory CVs ranged between 3.3 and 7.7%, 3.3 and 11.8% and 2.7 and 12.8% for corticosterone, 11-deoxycortisol and cortisone, with 1, 4 and 3 laboratories often exceeding the maximum allowable imprecision (MAI), respectively. Median inter-laboratory CVs were 10.0, 10.7 and 6.2%, with 38.5, 50.7 and 2.6% cases exceeding the MAI for corticosterone, 11-deoxycortisol and cortisone, respectively. Median laboratory bias vs. all laboratory-medians ranged from -5.6 to 12.3% for corticosterone, -14.6 to 12.4% for 11-deoxycortisol and -4.0 to 6.5% for cortisone, with few cases exceeding the total allowable error. Modest deviations were found in regression equations among most laboratories. External calibration did not improve 11-deoxycortisol and worsened corticosterone and cortisone inter-laboratory comparability. Conclusions: Method imprecision was variable. Inter-laboratory performance was reasonably good. However, cases with imprecision and total error above the acceptable limits were apparent for corticosterone and 11-deoxycortisol. Variability did not depend on calibration but apparently on imprecision, accuracy and specificity of individual methods. Tools for improving selectivity and accuracy are required to improve harmonization.

Details

Original languageEnglish
Pages (from-to)67-77
Number of pages11
JournalClinical chemistry and laboratory medicine
Volume61
Issue number1
Publication statusPublished - 1 Jan 2023
Peer-reviewedYes

External IDs

PubMed 36288389

Keywords

Keywords

  • 11-deoxycortisol, calibration, corticosterone, cortisone, harmonization, inter-laboratory performance, liquid chromatography - tandem mass spectrometry, method comparison, steroid hormones

Library keywords