Diagnostic Thresholds for Androgen-Producing Tumors or Pathologic Hyperandrogenism in Women by Use of Total Testosterone Concentrations Measured by Liquid Chromatography-Tandem Mass Spectrometry

The study aimed to establish diagnostic thresholds for total testosterone (TT) concentrations to screen for androgen-producing tumors (APTs) and postmenopausal pathologic hyperandrogenism using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). Conducted at the Mayo Clinic, the retrospective cohort study included 369 women with TT ≥3.5 nmol/L, of which 89 were analyzed. The study found that the diagnostic threshold for identifying APT in women with severe biochemical hyperandrogenemia was TT ≥5.1 nmol/L, with a sensitivity of 90% and specificity of 81%. For postmenopausal women, the threshold for pathologic hyperandrogenism was TT ≥2.2 nmol/L, with a sensitivity of 100% and specificity of 86%. The findings suggested that LC-MS/MS provided accurate thresholds for diagnosing these conditions.