Towards instant diagnostics: The role of ambient mass spectrometry devices in point-of-care clinical practice

ABSTRACT Ambient mass spectrometry (AMS) enables rapid, preparation-free molecular profiling and is increasingly impacting clinical diagnostics and point-of-care (POC) testing. Advances in soft/ambient ionization (DESI, DART, paper spray, MasSpec Pen, REIMS, PESI, and related hybrid sources) broaden analyte coverage, enabling real-time detection of metabolites, lipids, proteins, pathogens, drugs, and other biomarkers directly from tissues, biofluids, and swabs. In parallel, portable and miniaturized mass spectrometers have improved the feasibility of selected bedside, intraoperative, and field workflows, particularly for targeted screening and quantification. Machine-learning integration increasingly automates spectral interpretation for tissue classification, disease diagnosis, and therapeutic drug monitoring. However, routine clinical adoption remains constrained by standardization requirements, multicenter validation, and regulatory pathways. This review summarizes the evolution of AMS and portable MS, surveys emerging clinical applications, and outlines priorities for broader implementation. We also discuss workflow integration, quality assurance, data sharing, and training needs for non-specialist users.