Turnaround Time Research Articles

The next-generation magnetic recoil spectrometer (MRSnext) on OMEGA and NIF for diagnosing ion temperature, yield, areal density, and alpha heating.

The next-generation magnetic recoil spectrometer (MRSnext) is being designed to replace the current MRS at the National Ignition Facility and OMEGA for measurements of the neutron spectrum from an inertial confinement fusion implosion. The MRSnext will provide a far-superior performance and faster data turnaround than the current MRS systems, i.e., a 2× and 6× improvement in energy resolution at the NIF and OMEGA, respectively, and 20× improvement in data turnaround time. The substantially improved performance of the MRSnext is enabled by using electromagnets that provide a short focal plane (12-16cm) and unprecedented flexibility for a wide range of applications. In addition to being able to measure neutron yield, apparent ion temperature, areal density, and plasma-flow velocity over a wide range of yields, the NIF MRSnext will be able to directly, uniquely assess the alpha heating of the fuel ions through measurements of the alpha knock-on tail in the neutron spectrum. The goal is to implement a radiation-hard electronic detection system capable of providing rapid data acquisition and analysis. The development of the MRSnext will also set the foundation for the more advanced, time-resolving MRSt and serve as a testbed for its implementation on the NIF.

Half of oncologists fail to use ordered NGS results to guide their first-line treatment decision in advanced NSCLC: A retrospective study in a community-based integrated healthcare system

PurposeNext generation sequencing (NGS) testing is used to identify driver mutation(s) in non-small cell lung cancer (NSCLC) that are amenable to targeted therapy, resulting in superior outcomes and improved tolerability. We characterized how clinicians in a large integrated healthcare system utilized NGS testing to inform first line treatment decisions in patients with stage IV NSCLC shortly after diagnosis. MethodsWe conducted a cross-sectional study of 964 patients within an integrated healthcare system, Kaiser Permanente Southern California (KPSC), who were diagnosed with stage IV NSCLC and completed NGS testing (Strata Oncology) between May 2019 to June 2021. Treatment start dates were used to divide patients into those who started treatment before or after NGS results, or those who did not receive treatment after NGS results. Patients harboring alterations in seven genes (EGFR, ALK, ROS-1, BRAF, KRAS, RET, and MET) were considered candidates for targeted first line therapy. ResultsFirst line treatment was initiated in half (52 %; n = 284) of all treated patients prior to NGS results. Just under half (48 %; n = 137) of these patients were found to have a targetable mutation by NGS, of whom 59 % received first line chemotherapy and/or immunotherapy, rather than targeted therapy. Nearly 27 % of the sample never received treatment, of which 31 % had a targetable mutation, and may have been candidates for targeted therapy. Not undergoing first line treatment was correlated with older age, higher comorbidity index, smoking history, and the lack of an identifiable driver mutation. ConclusionNGS tests results were not exclusively used to inform first line treatment decisions in most patients with stage IV NSCLC, and most patients with a targetable mutation were not treated with targeted therapy. Possible explanations include lengthy turnaround times for NGS testing and the availability of timelier but less accurate single gene testing.

On-chip based power estimation for CMOS VLSI circuits using support vector machine

Power estimation has a major impact on the reliability of very-large-scale integration (VLSI) circuits. As a results power estimation is highly needed in VLSI circuits at the early stages. One of the evident challenges in integrated circuit (IC) industry is development and investigation of techniques for the reduction of design complexity due to the growing process variations and reduction of chip manufacturing turnaround time. Under these conditions, the higher design levels of average power estimation before the chip manufacturing process is highly essential for the calculation of power budget and to take the necessary steps for the reduction of power consumption. Over the years, most of the approaches were designed to estimate the power usage, however, most of the conventional techniques are time consuming, resource-intensive and largely manual. Machine learning techniques have received much attention in many of the engineering applications and are capable for modelling the complex systems through historical data. Hence, in this work on chip-based power estimation for complementary metal-oxide-semiconductor (CMOS) VLSI using support-vector machine (SVM) is presented to estimate the power. The SVM is employed to estimate the usage of power at runtime. The performance of this model is evaluated in terms of Power usage, delay, data accuracy and error rate.

Reducing turnaround time for routine outpatient biochemical tests through Lean Six Sigma: A case study in China.

Routine clinical biochemistry tests are crucial for clinical diagnostics and play a key role in enhancing outpatient turnover efficiency and patient satisfaction. This study aimed to implement Lean Six Sigma in the biochemistry laboratory of a hospital in China to improve efficiency and quality by reducing turnaround time. The study was conducted from January to December 2023, using the DMAIC (Define, Measure, Analyze, Improve, Control) framework, and employed tools such as the voice of the customer, Value Stream Mapping, '5 whys' technique, Nominal Group Technique, and Pareto chart. The turnaround time for outpatient routine clinical biochemistry tests was reduced from 139 min to 58 min (p < 0.05), effectively increasing both patient and physician satisfaction. Lean Six Sigma aimed to reduce the turnaround time for biochemical tests have significant advantages. This study confirms the effectiveness of Lean Six Sigma in a Chinese clinical laboratory setting and provides guidance for optimizing efficiency in global clinical laboratories with limited implementation experience, constrained technical and equipment resources, and high demand for medical diagnostics.

Исследование процессов тепломассопереноса в нефтяной скважине с~призабойным нагревателем различной длины

This paper considers a three-dimensional mathematical model of heat and mass transfer in an oil well with a bottom-hole heater. The vertical section of an oil well with an electric bottom-hole heater device for wells with highly viscous and paraffinic oil was investigated. The bottomhole heater is a monolithic cylinder located in the lower part of the tubing. The tubing contains perforations through which the oil fluid enters the tubing. The use of a local heater in the near-wellbore area makes it possible to increase the temperature of the fluid flowing through it, thereby reducing the viscosity of the oil and the load on the electric centrifugal pump, for which the critical value of the viscosity of the pumped medium is determined. The implementation of this model was carried out by the finite volume method using the ANSYS engineering simulation software. The geometry of finite elements and the finite volume mesh generated, an analogue of a continuous computational domain, were constructed by the MESH preprocessor. The finite volume mesh consists of polyhedral elements. Using the model, the fields of temperature, velocity and viscosity were obtained throughout the entire volume of the area under study. The curves showing the dependence of the average temperature of the cross section on the longitudinal coordinate of the tubing and the dependence of the average temperature at the inlet to an electric centrifugal pump on the heater power are presented. The viscosity value at the maximum permissible temperature of the heater, as well as the value of sufficient heater power to ensure uninterrupted pumping of petroleum liquid, were determined. The results obtained can be used to significantly improve the operating efficiency of an electric centrifugal pump, to increase the turnaround time and to reduce material costs during field development.

HOW DID THE E-COMMERCE FOR BEAUTY INDUSTRY DEVELOP IN KOREA COMPARED TO ROMANIA?

E-commerce has nowadays become a type of business that the younger generation prefer rather than industrial business due to the little costs of developing. The efficiency and fast turnaround time of a little investment in an e-commerce business makes people oriented towards. The reason for choosing the beauty industry for our analysis is that the industry gained numerous new white label products launched by various brands lately therefore e-commences embrace them and promote them properly. The beauty industry has now a greater number of consumers due to the various benefits such as skin care routine and careful face hygiene. Korea is one of the countries that produce and develop a strong industry having advanced technology for producing high quality beauty products. Romania is an import country of beauty products with an enormous interest in Korean skin care products and cosmetics. The two countries developed the idea of cosmetics business using online methods and e-commerce platforms. The purpose of this analysis is to find the differences of promoting an e-commerce of beauty products on different platforms such as Naver and Google while outlining the tendency of customers behaviors in two totally different societies but also the way businesses can develop online while optimizing using specific platform engines so they can improve their performances. Therefore, we analyze a literature review on the beauty industry development, how this proceeds online during and after pandemic and how important are those for the Romania and Korea population. The research will ensure a better view of both platforms Naver and Google and how those are helping the e-commerce business in the beauty industry. We will see a proper comparison between the society’s approach for e-commerce in both countries and an applied example on how this works for each culture.

A Cloud-Based System for Automated AI Image Analysis and Reporting.

Although numerous AI algorithms have been published, the relatively small number of algorithms used clinically is partly due to the difficulty of implementing AI seamlessly into the clinical workflow for radiologists and for their healthcare enterprise. The authors developed an AI orchestrator to facilitate the deployment and use of AI tools in a large multi-site university healthcare system and used it to conduct opportunistic screening for hepatic steatosis. During the 60-day study period, 991 abdominal CTs were processed at multiple different physical locations with an average turnaround time of 2.8min. Quality control images and AI results were fully integrated into the existing clinical workflow. All input into and output from the server was in standardized data formats. The authors describe the methodology in detail; this framework can be adapted to integrate any clinical AI algorithm.

A Highly Standardized Pre-Clinical Porcine Wound Healing Model Powered by Semi-Automated Histological Analysis.

The wound-healing process is a physiological response that begins after a disruption to the integrity of tissues present in the skin. To understand the intricacies involved in this process, many groups have tried to develop different in vitro models; however, the lack of a systemic response has, until this day, been the major barrier to the establishment of these models as the main study platform. Therefore, in vivo models are still the most common system for studying healing responses following different treatments, especially porcine models, which share several morphological similarities to the human skin. In this work, we developed a porcine excisional wound model and used semi-automated software as a strategy to generate quantitative morphometric results of healing responses by specific tissues and compartments. Our aim was to extract the most information from the model while producing reliable, reproducible, and standardized results. In order to achieve this, we established a 7-day treatment using a bacterial cellulose dressing as our standard for all the analyzed wounds. The thickness of the residual dermis under the wound (DUtW) bed was shown to influence the healing outcome, especially for the regeneration of epidermal tissue, including the wound closure rate. The analysis of the DUtW throughout the entire dorsal region of the animals opened up the possibility of establishing a map that will facilitate the experimental design of future works, increasing their standardization and reproducibility and ultimately reducing the number of animals needed. Thus, the developed model, together with the automated morphometric analysis approach used, offers the possibility to generate robust quantitative results with a rapid turnaround time while allowing the study of multiple extra morphometric parameters, creating a more holistic analysis.

Reflex Xpert MTB/XDR Testing of Residual Rifampicin-Resistant Specimens: A Clinical Laboratory-Based Diagnostic Accuracy and Feasibility Study in South Africa.

The World Health Organization-approved Xpert MTB/XDR test detects Mycobacterium tuberculosis and resistance to isoniazid, fluoroquinolones, ethionamide, and injectable drugs directly in specimens. This pragmatic, laboratory-based study assessed the diagnostic accuracy and feasibility of a reflex testing approach, where Xpert MTB/XDR was performed on residual specimens previously processed for Xpert MTB/RIF Ultra. Routine respiratory specimens, processed for Xpert MTB/RIF Ultra, were stored in sample reagent buffer at 2°C-8°C. If rifampicin resistant, the residual specimen was assessed for adequate volume (≥2 mL) and tested with Xpert MTB/XDR, with storage time recorded. A second specimen was used for routine and reference standard testing (culture and sequencing). Specimens (99% sputum) from 763 participants submitted to 2 large routine laboratories were included. Xpert MTB/XDR yielded valid resistance detection results in 639 (84%), compared with 507 (66%) for routine testing (difference [95% CI], 18% [13%-22%]). The median turnaround time for results was 23 hours for Xpert MTB/XDR and 15 days for routine testing. While 748 specimens (98%) were ≥2 mL, only 102 (13%) were stored for ≤4 hours. By the reference standard, 284 of 394 (72%) were isoniazid resistant, and 57 of 380 (15%) were fluroquinolone resistant. The sensitivities of Xpert MTB/XDR were 94% (95% CI, 91%-97%) for isoniazid and 91% (81%-97%) for fluoroquinolone resistance detection. The specificities were 98% (94%-100%) and 100% (98%-100%), respectively. Xpert MTB/XDR performed favorably compared with the reference, and the reflex testing approach increased results availability over routine testing, while dramatically decreasing turnaround time from weeks to hours. Laboratory workflow precluded testing within the manufacturer-recommended 4-hour storage time, but longer storage did not appear detrimental.

An Automated Real-Time PCR Assay versus Next-Generation Sequencing in the Detection of BRAF V600 Mutations in Melanoma Tissue Samples.

Next-generation sequencing (NGS) is the most commonly used method for determining BRAF mutational status in patients with advanced melanoma. Automated PCR-based methods, such as the IdyllaTM system, are increasingly used for mutation diagnostics, but it is unclear what impact the choice of diagnostic method has on the management of melanoma. To compare the concordance rate of BRAF V600 mutational analysis using IdyllaTM and NGS and to analyze the technical and clinical turnaround time. The clinical relevance is compared by analyzing the impact on the treatment decision. In this monocentric prospective cohort study, the BRAF mutation status of 51 patients was determined using both methods in parallel. BRAF V600 mutation was detected in 23/51 cases (45%). IdyllaTM showed a 100% concordant result with a faster turnaround time (0.2 days) compared to NGS (12.2 days). In general, less tumor material was required for IdyllaTM than for NGS. Most patients received immunotherapy as a first-line therapy regardless of the BRAF V600 status. IdyllaTM testing proved to be a reliable and rapid alternative to NGS in the determination of BRAF V600 mutation. Although BRAF. status was available earlier, this had no influence on the treatment decision in most cases.

Non-Genetic Healthcare Providers' Experiences and Perspectives with Rapid Genome-Wide Sequencing in Canadian Neonatal Intensive Care Units.

Rapid genome-wide sequencing (rGWS) continues to transform the care provided to infants with genetic conditions in neonatal intensive care units (NICUs). Previous research has demonstrated that rGWS has immense benefits on patient care; however, little is known about non-genetic healthcare providers' (HCPs) experiences and perspectives of working with rGWS and supporting families through the rGWS testing process in Canadian NICU facilities. To address this gap, we surveyed and conducted semi-structured interviews with non-genetic HCPs of diverse professions from NICUs in British Columbia. An interpretive description approach was used to analyze interview transcripts to identify patterns and variations in non-genetic HCPs' experiences and perceptions with rGWS. Participants had varying degrees of exposure to rGWS and levels of comfort with the testing process. Numerous barriers affecting the implementation of rGWS were identified, including low levels of comprehension of rGWS, longer turn-around times than expected, and having to apply for provincial government approval to access testing. Participants desired more education on rGWS, clear guidelines on the use of rGWS in NICUs, and resources for non-genetic HCPs and parents to support implementation. The results from this study can inform the development of workflows and educational resources on the use of rGWS in NICUs, helping to ensure that the NICU team is supported to optimize rGWS implementation.

A new assay falsely increases lactate dehydrogenase in plasma but not in serum

IntroductionSerum is the International Federation of Clinical Chemistry (IFCC)-recommended matrix for the measurement of lactate dehydrogenase (LD); however, many laboratories opt for lithium heparin plasma to achieve quicker turnaround times and minimize tube usage.When introducing the new Sigma-Strong IFCC-recommended LDH2 assay from Abbott Laboratories on lithium-heparin collected samples, we observed a rise in the patient median LD activity as well as several samples exhibiting falsely elevated values. Materials and methods120 + serum and plasma samples from consenting patients were collected and evaluated for complete blood count and lactate dehydrogenase using two different assays. Aggregated patient results before and after introduction of the LDH2 assay were compared. ResultsMean LD was 14% higher in plasma than in serum when using the LDH2 assay but only 5% higher when using the previous LDH legacy assay from Abbott Laboratories. Similarly, platelets and leukocytes were 10–30 times higher in plasma than in serum. Aggregated lactate dehydrogenase patient results demonstrated a dramatic increase in patient median following introduction of the LDH2 assay. Various experiments were tried to reduce cellular interference, but the only viable solution we found, apart from reverting to the LDH legacy assay, was to utilize serum tubes. ConclusionWe conclude that lithium-heparin plasma leads to falsely elevated lactate dehydrogenase activity when using the LDH2 assay. These errors can be prevented by using serum collected in gel separator tubes.

‘Plasma first’ approach for detecting epidermal growth factor receptor mutation in advanced non-small cell lung carcinoma

IntroductionThe treatment approach for recently diagnosed advanced non-small cell lung cancer (NSCLC) with EGFR mutations primarily relies on confirming the tissue diagnosis as non-squamous NSCLC. This routine clinical practice of tissue diagnosis imposes several barriers and delays in turnaround time (TAT) for biomarker testing, significantly delaying the time to treatment. The objective of this study is to investigate the ‘plasma first’ approach for detection of EGFR mutation in advanced stage treatment naïve NSCLC patients.MethodsWe prospectively collected blood samples of treatment naïve patients with clinical and radiological suspicion of advanced stage NSCLC prior to obtaining tissue biopsy. Plasma cfDNA was tested for EGFR mutation using two different methods. We compared the sensitivity and TAT of liquid biopsy with tissue biopsy.ResultsIn total, we analyzed plasma cell-free DNA (cfDNA) of 236 patients suspected of having advanced NSCLC for EGFR mutations. We observed a notably shorter turnaround time (TAT) of 3 days, which was significantly quicker compared to the 12-day TAT for tissue biopsy (p < 0.05). The ddPCR method had a sensitivity of 82.8%, which was higher than 66.34% sensitivity of ARMS-PCR. The current study also highlights that there is no significant difference in the clinical outcome of the patients whether treated based on liquid biopsy only or tissue biopsy (median progression-free survival of 11.56 vs. 11.9 months; p = 0.94).ConclusionsUtilizing a ‘plasma first’ strategy, given its shorter turnaround time, strong positive concordance and comparable outcomes to tissue biopsy, emerges as a highly specific and reliable method for detecting EGFR mutations in advanced-stage NSCLC.

Advances in Microflow Cytometry-Based Molecular Detection Methods for Improved Future MDS Cancer Diagnosis.

Myelodysplastic syndromes (MDS) are a rare form of early-stage blood cancer that typically leads to leukemia and other deadly complications. The typical diagnosis for MDS involves a mixture of blood tests, a bone marrow biopsy, and genetic analysis. Flow cytometry has commonly been used to analyze these types of samples, yet there still seems to be room for advancement in several areas, such as the limit of detection, turnaround time, and cost. This paper explores recent advancements in microflow cytometry technology and how it may be used to supplement conventional methods of diagnosing blood cancers, such as MDS and leukemia, through flow cytometry. Microflow cytometry, a more recent adaptation of the well-researched and conventional flow cytometry techniques, integrated with microfluidics, demonstrates significant potential in addressing many of the shortcomings flow cytometry faces when diagnosing a blood-related disease such as MDS. The benefits that this platform brings, such as portability, processing speed, and operating cost, exemplify the importance of exploring microflow cytometry as a point-of-care (POC) diagnostic device for MDS and other forms of blood cancer.

Comparison of the Direct Identification and Short-Term Incubation Methods for Positive Blood Cultures via MALDI-TOF Mass Spectrometry.

Timely pathogen identification in bloodstream infections is crucial for patient care. A comparison is made between positive blood culture (BC) pellets from serum separator tubes using a direct identification (DI) method and colonies on agar plates from a short-term incubation (STI) method with a matrix-assisted laser desorption/ionization Biotyper for the evaluation of 354 monomicrobial BCs. Both the DI and STI methods exhibited similar identification rates for different types of bacteria, except for Gram-positive and anaerobic bacteria. The DI method's results aligned closely with the STI method's results for Enterobacterales, glucose-non-fermenting Gram-negative bacilli (GNB), and carbapenem-resistant Enterobacterales. The DI method exhibited high concordance with the conventional method for GNB identification, achieving 88.2 and 87.5% accuracy at the genus and species levels, respectively. Compared with the STI method, the DI method showed a less successful performance for Gram-positive bacterial identification (50.5 vs. 71.3%; p < 0.01). The DI method was useful for anaerobic bacterial identification of slow-growing microorganisms without any need for colony growth, unlike in the STI method (46.7 vs. 13.3%; p = 0.04). However, both methods could not identify yeast in positive BCs. Overall, the DI method provided reliable results for GNB identification, offering many advantages over the STI method by significantly reducing the turnaround time and enabling quicker pathogen identification in positive BCs.

Comparative assessment of three commercial kits and in house optimized PCR assays for GMO screening in food and feed

Screening strategies for GMO detection in food and feed are a crucial aspect in GMO testing laboratories for streamlining the analytical workflow and reducing turnaround time and costs. These strategies can be more or less complex or even be targeted according to the ingredients in the product, but whatever the choice, a good basic approach is generally based on the search for 35S promoter (P35S), nos-terminator (T-nos) and FMV promoter (P-FMV). In this study, we compare the singleplex real time PCR method for P35S, T-nos and P-FMV detection currently adopted by the Italian National Reference Laboratory for GM food and feed (NRL) with three commercial kits available on the market for giving a greater choice to consider the best approach suitable to the official control laboratories that are different from each other.•The NRL optimized singleplex PCR methods and the three commercial kits fully respect all the validation parameters criteria according to the minimum performance requirements (MPR) of ENGL [1]•Screening strategies for GMO detection in food and feed are a crucial aspect in GMO testing laboratories and being the commercial kits different from each other, the laboratory can choose the methods best suit their needs reducing turnaround time and costs.

Evaluation of a commercial Real Time PCR for clinical samples without RNA extraction for detection of SARS-CoV-2

RT-PCR is the gold standard for diagnosis of COVID-19. All RT-PCR kits are based on RNA extraction from the clinical sample. There was a sudden increase in demand of these kits, both RNA extraction and COVID-19 RT-PCR kits during the pandemic. This sudden spurt in global demand created a situation of shortage of consumables, especially the RNA extraction kits. Hence, this study was carried out to evaluate and compare COVID-19 RT-PCR without RNA extraction step using buffer R3. Sensitivity, specificity and accuracy of RT-PCR kit without RNA extraction were 89.16 %, 100% and 89.6% respectively. This approach saved more than 50 % time compared to the RT-PCR kit with RNA extraction approach allowing enhanced daily sample processing capability. RT-PCR kit without RNA extraction help in managing a greater number of samples, reduces cost and turnaround time.

Enhancing efficiency in detection of COVID-19 through AI-driven colorimetric isothermal detection with multiplex primers

COVID-19 has afflicted millions of lives worldwide. Although there are many rapid methods to detect it based on colorimetric loop-mediated isothermal amplification, there remains room for improvement. This study aims to 1) integrate multiple primers into a singleplex assay to enhance the diagnostic sensitivity, and 2) utilize a high-throughput smartphone-operatable AI-driven color reading tool to enable a rapid result analysis. This setup can improve the sensitivity by 10–100 times and can analyze approximately 6700 samples per minute. The assay is simpler than RT-qPCR, with a turnaround time of less than 75 min. It can detect various types of SARS-CoV-2 by targeting 3 genes, increasing the likelihood that it will remain effective even if the virus undergoes mutations in any single target gene. In summary, it affords potential for adaptation to detection of new/re-emerging diseases with the visual readout for maximum assay simplicity and AI-operated mode for large-scale testing.

Clinical Utility of Optical Genome Mapping for Improved Cytogenomic Analysis of Gliomas.

A glioma is a solid brain tumor which originates in the brain or brain stem area. The diagnosis of gliomas based on standard-of-care (SOC) techniques includes karyotyping, fluorescence in situ hybridization (FISH), and chromosomal microarray (CMA), for detecting the pathogenic variants and chromosomal abnormalities. But these techniques do not reveal the complete picture of genetic complexity, thus requiring an alternative technology for better characterization of these tumors. The present study aimed to evaluate the clinical performance and feasibility of using optical genome mapping (OGM) for chromosomal characterization of gliomas. Herein, we evaluated 10 cases of gliomas that were previously characterized by CMA. OGM analysis showed concordance with the results of CMA in identifying the characterized Structural Variants (SVs) in these cases. More notably, it also revealed additional clinically relevant aberrations, demonstrating a higher resolution and sensitivity. These clinically relevant SVs included cryptic translocation, and SVs which are beyond the detection capabilities of CMA. Our analysis highlights the unique capability of OGM to detect all classes of SVs within a single assay, thereby unveiling clinically significant data with a shorter turnaround time. Adopting this diagnostic tool as a standard of care for solid tumors like gliomas shows potential for improving therapeutic management, potentially leading to more personalized and timely interventions for patients.

The effect of examining somatic alterations with NGS in patients with solid tumors, on patient management: A single-center experience in Turkey.

This study aimed to investigate the impact of analyzing somatic alterations using next-generation sequencing (NGS) on treatment management in patients with metastatic solid cancers and their ability to access NGS recommended treatments. This retrospective study included eligible patients who underwent NGS on somatic tumor tissue. We examined the clinical and pathological characteristics of these patients and the alterations in their treatment following NGS results. A total of 101 patients who underwent NGS were included in the study. The most common cancers were non-small cell lung cancer (NSCLC), colorectal, and breast cancers, in that order. The median age was 58 (range 21-82) years, with 60 (59.4%) male participants. The median NGS turnaround time was 23 (range 17-29) days. NGS was performed on tissue from the primary lesion in 89(88%) patients. Predictive, prognostic, actionable, or variants of unknown significance were detected in 62(61.4%) patients. The most frequent variants identified were KRAS, EGFR, TP53, PIK3CA, and other rare mutations. Treatment was altered in 17(16.8%) patients based on NGS results. Of the 30 (29.7%) patients for whom NGS-informed treatment was recommended, only seven (6.9%) received the recommended therapy. There was no significant difference in overall survival (OS) between patients whose treatment was changed based on NGS results and those whose treatment remained unchanged (p = 0.897). There was no difference in OS between patients with and without variants (p = 0.384). NGS analysis of somatic alterations in patients with metastatic cancer may reveal additional variants beyond those identified by baseline tests. However, based on the recommendations of the reimbursement institution in Turkey, only a limited number of patients are able to access treatments recommended by NGS results. Therefore, baseline tests established in Turkey need to be made available in more centers in an appropriate time.