Interlaboratory Trial Research Articles

Development of a framework for genotyping bovine-derived Cryptosporidium parvum, using a multilocus fragment typing tool.

BackgroundThere is a need for an integrated genotyping approach for C. parvum; no sufficiently discriminatory scheme to date has been fully validated or widely adopted by veterinary or public health researchers. Multilocus fragment typing (MLFT) can provide good differentiation and is relatively quick and cheap to perform. A MLFT tool was assessed in terms of its typeability, specificity, precision (repeatability and reproducibility), accuracy and ability to genotypically discriminate bovine-derived Cryptosporidium parvum.MethodsWith the aim of working towards a consensus, six markers were selected for inclusion based on their successful application in previous studies: MM5, MM18, MM19, TP14, MS1 and MS9. Alleles were assigned according to the fragment sizes of repeat regions amplified, as determined by capillary electrophoresis. In addition, a region of the GP60 gene was amplified and sequenced to determine gp60 subtype and this was added to the allelic profiles of the 6 markers to determine the multilocus genotype (MLG). The MLFT tool was applied to 140 C. parvum samples collected in two cross-sectional studies of UK calves, conducted in Cheshire in 2004 (principally dairy animals) and Aberdeenshire/Caithness in 2011 (beef animals).ResultsTypeability was 84 %. The primers did not amplify tested non-parvum species frequently detected in cattle. In terms of repeatability, within- and between-run fragment sizes showed little variability. Between laboratories, fragment sizes differed but allele calling was reproducible. The MLFT had good discriminatory ability (Simpson’s Index of Diversity, SID, was 0.92), compared to gp60 sequencing alone (SID 0.44). Some markers were more informative than others, with MS1 and MS9 proving monoallelic in tested samples.ConclusionsFurther inter-laboratory trials are now warranted with the inclusion of human-derived C. parvum samples, allowing progress towards an integrated, standardised typing scheme to enable source attribution and to determine the role of livestock in future outbreaks of human C. parvum.

Comparison of integrated genotoxicity endpoints in rats after acute and subchronic oral doses of 4-nitroquinoline-1-oxide.

During interlaboratory validation trials for the Pig-a gene mutation assay we assessed the genotoxicity of 4-nitroquinoline-1-oxide (4NQO) across endpoints in multiple tissues: induction of Pig-a mutant red blood cells (RBCs) and reticulocytes (RETs); micronucleated RETs (MN RETs); and DNA damage in blood and liver via the alkaline Comet assay (%tail intensity [TI]). In a previous subchronic toxicity study with 28 daily doses, biologically meaningful increases were observed only for Pig-a mutant RBCs/RETs while marginal increases in the frequency of MN RET were observed, and other clastogenic endpoints were negative. Follow up acute studies were performed using the same cumulative doses (0, 35, 70, 105, and 140 mg/kg) administered in a bolus, or split over three equal daily doses, with samples collected up to 1 month after the last dose. Both of the acute dosing regimens produced similar results, in that endpoints were either positive or negative, regardless of 1 or 3 daily doses, but the three consecutive daily dose regimen yielded more potent responses in TI (in liver and blood) and Pig-a mutant frequencies. In these acute studies the same cumulative doses of 4NQO induced positive responses in clastogenic endpoints that were negative or inconclusive using a subchronic study design. Additionally, a positive control group using combination doses of cyclophosphamide and ethyl methanesulfonate was employed to assess assay validity and potentially identify a future positive control treatment for integrated genetic toxicity studies.

Clinical Neuropathology practice guide 5-2015: MGMT methylation pyrosequencing in glioblastoma: unresolved issues and open questions.

O6-methylguanine-methyltransferase (MGMT) promoter methylation status has prognostic and, in the subpopulation of elderly patients, predictive value in newly diagnosed glioblastoma. Therefore, knowledge of the MGMT promoter methylation status is important for clinical decision-making. So far, MGMT testing has been limited by the lack of a robust test with sufficiently high analytical performance. Recently, one of several available pyrosequencing protocols has been shown to be an accurate and robust method for MGMT testing in an intra- and interlaboratory ring trial. However, some uncertainties remain with regard to methodological issues, cut-off definitions, and optimal use in the clinical setting. In this article, we highlight and discuss several of these open questions. The main unresolved issues are the definition of the most relevant CpG sites to analyze for clinical purposes and the determination of a cut-off value for dichotomization of quantitative MGMT pyrosequencing results into “MGMT methylated” and “MGMT unmethylated” patient subgroups as a basis for further treatment decisions.

Mycotoxin monitoring for commercial foodstuffs in Taiwan

Mycotoxins are toxic food contaminants that are naturally produced by certain fungi. They induce negative effects on human health by making food unsafe for consumption. In this study, analyses were performed to determine the levels and incidence of aflatoxins (AFs) in peanut products, tree nuts, spices, and Coix seeds; ochratoxin A (OTA) in wheat and roasted coffee, as well as OTA and AFs in rice; and citrinin (CIT) in red yeast rice (RYR) products. A total of 712 samples from nine different food categories were collected between 2012 and 2013. The samples were analyzed over 2 years for AFs, OTA, and CIT by methods recommended by the Ministry of Health and Welfare. These official analytical methods were extensively validated in-house and through interlaboratory trials. The analytical values of suspected contaminated specimens were confirmed by liquid chromatography – tandem mass spectrometry analysis to identify the specific mycotoxin present in the sample. We show that 689 samples (96.8%) complied with the regulations set by the Ministry of Health and Welfare. AFs were found in four peanut-candy products, one peanut-flour product, one pistachio product, one Sichuan-pepper product, and one Coix seed product. All had exceeded the maximum levels of 15 parts per billion for peanut and 10 parts per billion for other food products. Furthermore, 14 RYR samples contained CIT above 5 parts per million, and one RYR tablet exceeded the maximum amount allowed. Instances of AFs in substandard Sichuan pepper and Coix seeds were first detected in Taiwan. Measures were taken by the relevant authorities to remove substandard products from the market in order to decrease consumer exposure to mycotoxin. Border control measures were applied to importing food commodities with a higher risk of mycotoxin contamination, such as peanut, Sichuan pepper, and RYR products. Declining trends were observed in the noncompliance rate of AFs in peanut products, as well as that of CIT in RYR raw materials monitored from 2010 to 2013.

Validated Method for the Characterization and Quantification of Extractable and Nonextractable Ellagitannins after Acid Hydrolysis in Pomegranate Fruits, Juices, and Extracts.

Pomegranates are one of the main highly valuable sources of ellagitannins. Despite the potential health benefits of these compounds, reliable data on their content in pomegranates and derived extracts and food products is lacking, as it is usually underestimated due to their complexity, diversity, and lack of commercially available standards. This study describes a new method for the analysis of the extractable and nonextractable ellagitannins based on the quantification of the acid hydrolysis products that include ellagic acid, gallic acid, sanguisorbic acid dilactone, valoneic acid dilactone, and gallagic acid dilactone in pomegranate samples. The study also shows the occurrence of ellagitannin C-glycosides in pomegranates. The method was optimized using a pomegranate peel extract. To quantify nonextractable ellagitannins, freeze-dried pomegranate fruit samples were directly hydrolyzed with 4 M HCl in water at 90 °C for 24 h followed by extraction of the pellet with dimethyl sulfoxide/methanol (50:50, v/v). The method was validated and reproducibility was assessed by means of an interlaboratory trial, showing high reproducibility across six laboratories with relative standard deviations below 15%. Their applicability was demonstrated in several pomegranate extracts, different parts of pomegranate fruit (husk, peels, and mesocarp), and commercial juices. A large variability has been found in the ellagitannin content (150-750 mg of hydrolysis products/g) and type (gallagic acid/ellagic acid ratios between 4 and 0.15) of the 11 pomegranate extracts studied.

Identification of Highly Pathogenic Microorganisms by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry: Results of an Interlaboratory Ring Trial.

In the case of a release of highly pathogenic bacteria (HPB), there is an urgent need for rapid, accurate, and reliable diagnostics. MALDI-TOF mass spectrometry is a rapid, accurate, and relatively inexpensive technique that is becoming increasingly important in microbiological diagnostics to complement classical microbiology, PCR, and genotyping of HPB. In the present study, the results of a joint exercise with 11 partner institutions from nine European countries are presented. In this exercise, 10 distinct microbial samples, among them five HPB, Bacillus anthracis, Brucella canis, Burkholderia mallei, Burkholderia pseudomallei, and Yersinia pestis, were characterized under blinded conditions. Microbial strains were inactivated by high-dose gamma irradiation before shipment. Preparatory investigations ensured that this type of inactivation induced only subtle spectral changes with negligible influence on the quality of the diagnosis. Furthermore, pilot tests on nonpathogenic strains were systematically conducted to ensure the suitability of sample preparation and to optimize and standardize the workflow for microbial identification. The analysis of the microbial mass spectra was carried out by the individual laboratories on the basis of spectral libraries available on site. All mass spectra were also tested against an in-house HPB library at the Robert Koch Institute (RKI). The averaged identification accuracy was 77% in the first case and improved to >93% when the spectral diagnoses were obtained on the basis of the RKI library. The compilation of complete and comprehensive databases with spectra from a broad strain collection is therefore considered of paramount importance for accurate microbial identification.

Evaluation and validation of rapid molecular methods for the detection and identification of microorganisms in water – Standard Operating Procedures

Molecular techniques are emerging as a rapid and powerful approach for microorganism detection. This project reviewed the efficacy of PCR assays for Cryptosporidium, Microcystis, adenovirus and ammonia oxidising bacteria, as well as candidate techniques for DNA extraction and inhibitor removal. The literature review led to an evaluation of DNA extraction kits and reagents for PCR; finalisation of assay formats; the development of PCR controls and Standard Operating Procedures (SOP); analysis of assay robustness using real samples; and completion of an Inter-laboratory trial using the SOP's developed.This book is co-published with Water Research AustraliaThis title belongs to WaterRAISBN: 9781780407524 (eBook)ISBN: 9781780407517 (Print)

Recommendation for a Standardised Method of Broth Microdilution Susceptibility Testing for Porcine Bordetella bronchiseptica.

The objective was to establish and standardise a broth microdilution susceptibility testing method for porcine Bordetella (B.) bronchiseptica. B. bronchiseptica isolates from different geographical regions and farms were genotyped by macrorestriction analysis and subsequent pulsed-field gel electrophoresis. One reference and one type strain plus two field isolates of B. bronchiseptica were chosen to analyse growth curves in four different media: cation-adjusted Mueller-Hinton broth (CAMHB) with and without 2% lysed horse blood, Brain-Heart-Infusion (BHI), and Caso broth. The growth rate of each test strain in each medium was determined by culture enumeration and the suitability of CAMHB was confirmed by comparative statistical analysis. Thereafter, reference and type strain and eight epidemiologically unrelated field isolates of B. bronchiseptica were used to test the suitability of a broth microdilution susceptibility testing method following CLSI-approved performance standards given in document VET01-A4. Susceptibility tests, using 20 antimicrobial agents, were performed in five replicates, and data were collected after 20 and 24 hours incubation and statistically analysed. Due to the low growth rate of B. bronchiseptica, an incubation time of 24 hours resulted in significantly more homogeneous minimum inhibitory concentrations after five replications compared to a 20-hour incubation. An interlaboratory comparison trial including susceptibility testing of 24 antimicrobial agents revealed a high mean level of reproducibility (97.9%) of the modified method. Hence, in a harmonization for broth microdilution susceptibility testing of B. bronchiseptica, an incubation time of 24 hours in CAMHB medium with an incubation temperature of 35°C and an inoculum concentration of approximately 5 x 105 cfu/ml was proposed.

生物応答を用いた排水試験法案の検証と事業場排水の実態調査

In view of developing a bioassay for use into effluent management system in Japan, short-term toxicity tests using fish, daphnids, and algae were selected as a battery of bioassays, which evaluate the integrated effect of effluent, and "a draft protocol of bioassays for effluent testing" has been prepared. To examine the robustness, sensitivity and reproducibility of the draft protocol, we conducted an inter-laboratory trial where the same effluent was tested by 9 laboratories in Japan. No observed effect concentrations (NOEC) of the test effluent in all the laboratories were within the median +/-1 dilutions, suggesting that the variability between laboratories was at acceptable level. Furthermore, testing of reference chemicals by 10 testing laboratories showed that the reproducibility of the bioassays was relatively higher than that exhibited in the inter-laboratory validation of similar bioassays conducted by US EPA. However, the percentage of minimum significant difference (PMSD) and control coefficient of variation (CV) in the almost all the Japanese laboratories were at acceptable levels (as appears in the US EPA report), indicating that the intra-laboratory precision and the sensitivity of each test was sufficient. We investigated the value of using IC20 for fish, IC25 for daphnids, and IC5 for algae as an alternative to NOEC. With this approach, toxicity survey of 91 effluent samples conducted from 2008 to 2013 found that 36% of effluents were toxic to at least one of the three test species even after 10-fold dilution. The test species that demonstrated toxic effects were different in each sample; thus, we suggest that effluent toxicity evaluation should be based on more than one species due to different sensitivities.

European interlaboratory comparison of detection methods for “flavescence dorée” phytoplasma: preliminary results

A working group was established in the frame of EUPHRESCO Phytosanitary ERA-NET Project aimed to compare and validate diagnostic protocols for the detection of “flavescence doree” phytoplasma in grapevine. Seven molecular protocols were compared in interlaboratory trials starting from extracted DNAs prepared in one laboratory. The tested molecular protocols consisted of universal and group-specific real-time and conventional nested PCR assays. Real-time PCR protocols, generally, revealed higher values of diagnostic sensitivity and diagnostic specificity than conventional PCR protocols. These preliminary results require a statistical analysis to confirm the performances of the protocols.

Simultaneous extraction and determination of various pesticides in environmental waters.

A simple and rapid method was developed for the simultaneous analysis of nine different pesticides in water samples by gas chromatography with mass spectrometry. A number of parameters that may affect the recovery of pesticides, such as the type of solid-phase extraction cartridge, eluting solvent in single or combination and their volumes, and water pH value were investigated. It showed that three solid-phase extraction cartridges (Strata-X, Oasis HLB, and ENVI-18) produced the greatest recovery while ethyl acetate/dichloromethane/acetone (45:10:45, 12 mL) followed by dichloromethane (6 mL) was efficient in eluting target pesticides from solid-phase extraction cartridges. Different water pH values (4-9) did not show a significant effect on the pesticides recovery. The optimized method was verified by performing spiking experiments with a series of concentrations (0.002-10 μg/L) in waters, with good linearity, recovery, and reproducibility for most compounds. The limit of detection and limit of quantification of this optimized method were 0.01-2.01 and 0.02-6.71 ng/L, respectively, much lower than the European Union environmental quality standard for the pesticides (0.1 μg/L) in waters. The proposed method was further validated by participation in an interlaboratory trial. It was then subsequently applied to river waters from north-east Scotland, UK, for the determination of the target pesticides.

Results of an International Interlaboratory Trial to Determine Twelve Allergens Using Real-time PCR- and ELISA-based Assays.

To elucidate the capability of laboratories to determine allergen contents, an international interlaboratory trial was conducted using meat products spiked with 12 allergens. The measurement uncertainty was calculated independent of the applied method simulating realistic situations when comparing analysis certificates from different laboratories. The measurement uncertainty was revealed to be in the best cases +/-100%, in the worst cases quantification exhibited a measurement uncertainty of higher than 200% making quantitative analysis impossible. The measurement uncertainty seemed to depend on the analyte and assays used.

Inter-laboratory ring trials to evaluate serological methods for dourine diagnosis

To evaluate the reproducibility of routine serological methods to detect Trypanosoma equiperdum antibodies in equine sera, two inter-laboratory ring trials were organized involving 22 European and 4 non-European reference laboratories for dourine. The serological methods were the complement fixation test (CFT; 25 laboratories) and the indirect fluorescent antibody test (IFAT; 4 laboratories). Three of the laboratories applied both these methods. The sample panels were composed of sera that were negative, positive or suspected for dourine. Of the negative sera, one was from a donkey naturally infected with Trypanosoma evansi. This study confirmed the reliability of CFT and highlighted its inter-laboratory reproducibility for known T. equiperdum positive and negative sera. However the reproducibility was less good for sera positive for T. evansi or of unknown status, e.i. nine out of 22 laboratories observed a false-positive result with the T. evansi-positive serum, whether by CFT or IFAT. This interesting result suggests that the specificity of dourine serodiagnosis may be improved by standardizing the critical reagents, including antigens and by developing a standard T. equiperdum serum which could be used calibrate test systems across multiple laboratories. Trial data confirmed seropositivity in one of the three horses suspected of dourine. It may be beneficial to generalize the use of a suitable low-titer serum control, derived from a standard serum in order to standardize the method's detection limit.

Estimating the Contribution of Sampling, Sample Pretreatment, and Analysis in the Total Uncertainty Budget of Agricultural Soil pH and Organic Carbon Monitoring

Monitoring of soil organic carbon (SOC) and pH is needed to manage soil protection and tackle possible degradation in support of, i.e, the upcoming European Soil Framework Directive. Harmonized monitoring procedures and protocols produced under the auspices of the International Organization for Standardization (ISO) and the European Committee for Standardization (CEN) will be recommended. The uncertainty contributions of sampling, sample pretreatment, and analysis in the monitoring of soil pH and organic carbon in agricultural parcels using these harmonized monitoring procedures have been studied.A within-laboratory comparison between the different analytical methods and sample pretreatments was made on 451 soil samples for SOC and 150 samples for soil acidity. Thereafter, a field study was performed to evaluate the contribution of the sampling method. Finally, an interlaboratory trial (including sampling) was organized to assess the overall monitoring uncertainty.The results indicate that the influence of different sample pretreatments (e.g., milling) in combination with different analytical methods (elemental combustion versus chemical oxidation) are the main contributions to the observed uncertainty in the monitoring of SOC. For the monitoring of soil acidity, a similar observation was made, showing that differences in the practical implementation of the analytical method (e.g., mechanical shaking) are the main contributions to the monitoring uncertainty. The monitoring uncertainties derived from an interlaboratory trial (including sampling) amounted to ±20% (95% confidence interval, CI) for SOC and ±0.3 pH units (95% CI) for soil acidity on an agricultural parcel.

Inter-laboratory Testing of GMO Detection by Combinatory SYBR®Green PCR Screening (CoSYPS)

Combinatory SYBR®Green real-time PCR Screening (CoSYPS) is an efficient, sensitive approach for detecting complex targets such as genetically modified organisms (GMOs) in food and feed products. GMO analysis for legal purposes has become increasingly complex and costly due to the diversity in recombinant targets present in the different GMOs. For this reason, screening for the presence of GMOs is in general the first step in the detection of GM material in a product. CoSYPS allows detecting the large majority of globally commercial GMOs using SYBR®Green real-time PCR methods for six GM targets (P35S, Tnos, CryIAb, CP4-EPSPS, PAT and BAR) combined with species-specific PCR methods (e.g., maize, soy, rapeseed). Here, the results of an inter-laboratory trial on seven samples with different GMO mixtures at different levels are presented. In total, 13 laboratories participated in the trial and the currently most frequently used PCR analysis platforms are represented. The inter-laboratory study clearly demonstrates that PCR methods used in CoSYPS form a very robust GMO screening system. Sensitivity, specificity, positive and negative predictive values are for all PCR methods higher than 95 % for all samples. Together, these results show that the SYBR®Green real-time PCR methods used in CoSYPS are effectively applicable to different PCR platforms and amendable to configuration into a sensitive high-throughput GMO screening and decision support tool.

Quality control ranges for cefoperazone 30 μg disks for Staphylococcus aureus ATCC® 25923 and Escherichia coli ATCC® 25922

The third generation cephalosporin cefoperazone is commonly used for bovine mastitis therapy. So far, the cefoperazone susceptibility testing using 30μg disks was hampered by the lack of quality control (QC) ranges and the respective interpretive criteria. The aim of this study was to develop CLSI-approved QC ranges for Staphylococcus aureus ATCC® 25923 and Escherichia coli ATCC® 25922. An interlaboratory trial including eight laboratories was conducted. Each laboratory tested both QC reference strains ten times using two lots of cefoperazone 30μg disks and three lots of Mueller–Hinton agar. The results were analysed by using the published statistical analysis method. Based on the data, zone diameters of 23–34mm and 24–33mm were established as QC ranges for the 30μg disk and S. aureus ATCC® 25923 and E. coli ATCC® 25922, respectively. These new QC ranges have been recently approved by the Clinical and Laboratory Standards Institute and will help diagnostic laboratories to validate their cefoperazone testing results using 30μg disks.

Limited interlaboratory comparison of Schmallenberg virus antibody detection in serum samples

Eight veterinary institutes in seven different countries in Europe participated in a limited interlaboratory comparison trial to evaluate laboratory performances of Schmallenberg virus (SBV) antibody detection in serum. Seven different...

Interlaboratory comparison of two AOAC liquid chromatographic fluorescence detection methods for paralytic shellfish toxin analysis through characterization of an oyster reference material.

An interlaboratory ring trial was designed and conducted by the Centre for Environment, Fisheries, and Aquaculture Science to investigate a range of issues affecting the analysis of a candidate Pacific oyster paralytic shellfish toxin reference material. A total of 21 laboratories participated in the study and supplied results using one or more of three instrumental methods, specifically precolumn oxidation (Pre-COX) LC with fluorescence detection (FLD; AOAC Official Method 2005.06), postcolumn oxidation (PCOX) LC-FLD (AOAC Official Method 2011.02), and hydrophilic interaction LC/MS/MS. Each participant analyzed nine replicate samples of the oyster tissue in three separate batches of three samples over a period of time longer than 1 week. Results were reported in a standardized format, reporting both individual toxin concentrations and total sample toxicity. Data were assessed to determine the equivalency of the two AOAC LC methods and the LC/MS/MS method as well as an assessment of intrabatch and interbatch repeatability and interlaboratory reproducibility of each method. Differences among the results reported using the three methods were shown to be statistically significant, although visual comparisons showed an overlap between results generated by the majority of tests, the exception being the Pre-COX quantitation of N-hydroxylated toxins in post ion-exchange fractions. Intralaboratory repeatability and interlaboratory reproducibility were acceptable for most of the results, with the exception of results generated from fractions. The results provided good evidence for the acceptable performance of the PCOX method for the quantitation of C toxins. Overall the study showed the usefulness of interlaboratory analysis for the characterization of paralytic shellfish poisoning matrix reference materials, highlighting some issues that may need to be addressed with further method assessment at individual participant laboratories.

Towards the PCR-based identification of Palaearctic Culicoides biting midges (Diptera: Ceratopogonidae): results from an international ring trial targeting four species of the subgenus Avaritia.

BackgroundBiting midges of the genus Culicoides (Diptera: Ceratopogonidae) are biological vectors of internationally important arboviruses. To understand the role of Culicoides in the transmission of these viruses, it is essential to correctly identify the species involved. Within the western Palaearctic region, the main suspected vector species, C. obsoletus, C. scoticus, C. dewulfi and C. chiopterus, have similar wing patterns, which makes it difficult to separate and identify them correctly.MethodsIn this study, designed as an inter-laboratory ring trial with twelve partners from Europe and North Africa, we assess four PCR-based assays which are used routinely to differentiate the four species of Culicoides listed above. The assays based on mitochondrial or ribosomal DNA or microarray hybridisation were tested using aliquots of Culicoides DNA (extracted using commercial kits), crude lysates of ground specimens and whole Culicoides (265 individuals), and non-Culicoides Ceratopogonidae (13 individuals) collected from across Europe.ResultsA total of 800 molecular assays were implemented. The in-house assays functioned effectively, although specificity and sensitivity varied according to the molecular marker and DNA extraction method used. The Obsoletus group specificity was overall high (95-99%) while the sensitivity varied greatly (59.6-100%). DNA extraction methods impacted the sensitivity of the assays as well as the type of sample used as template for the DNA extraction.ConclusionsThe results are discussed in terms of current use of species diagnostic assays and the future development of molecular tools for the rapid differentiation of cryptic Culicoides species.

Clinical Neuropathology practice news 1-2014: Pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma

Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin-fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing-based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing.