The fluorescence lifetime of NADH in live cells is an indicator of the metabolic state and, consequently, a discrimination parameter between normal and tumor cells. However, the fluorescence lifetime of NADH also depends on the cell type and on the mitochondrial pH. The task is therefore to find a FLIM signature that describes the metabolic state without being influenced by other parameters. We show that the ratio of the amplitudes of the decay components, a1/a2, of NADH is an absolute parameter for discriminating normal cells from tumor cells, and outline the technical requirements for metabolic FLIM for clinical use.
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