Biological effects of the Auger emitter iodine-125: a review. Report No. 1 of AAPM Nuclear Medicine Task Group No. 6.

The biological implications of Auger electron cascades following inner shell ionization of atoms have been of interest for over 25 years. By virtue of their decay via orbital electron capture and/or internal conversion, several biomedical radionuclides emit numerous low-energy electrons spontaneously. The biological effects of such radionuclides incorporated into tissues cannot be predicted a priori because of the highly localized patterns of energy deposition by the electrons. Results of extensive research using Iodine-125 as a model Auger electron emitter are now available. This article presents an up-to-date review of the physical and radiobiological data on this Auger emitter. Valuable concepts concerning the action of internal Auger emitters are identified phenomenologically, and questions that need to be answered are indicated. The present understanding provides a scientific basis toward estimation of risk associated with Auger emitters used in diagnosis, and suggests potential applications to therapy.