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Over the past 15 years, fluorescence has become the dominant detection/sensing technology in medical diagnostics and biotechnology. Although fluorescence is a highly sensitive technique, where single molecules can readily be detected, there is still a drive for reduced detection limits. The detection of a fluorophore is usually limited by its quantum yield, autofluorescence of the samples and/or the photostability of the fluorophores; however, there has been a recent explosion in the use of metallic nanostructures to favorably modify the spectral properties of fluorophores and to alleviate some of these fluorophore photophysical constraints. The use of fluorophore–metal interactions has been termed radiative decay engineering, metal-enhanced fluorescence or surface-enhanced fluorescence.