Radionuclide decay by electron capture and/or internal conversion is a
ccompanied by complex atomic vacancy cascades and emission of low-ener
gy electrons, resulting in a highly charged daughter atom and a high d
ensity of electron irradiation in the immediate vicinity of the decay
site. The molecular and cellular consequences of such decay events inc
lude DNA strand breaks, mutations, chromosome aberrations, malignant t
ransformation, division delay, and cell death. Damage to cells depends
largely on the intracellular location of the radionuclide, Decays out
side the cell nucleus produce low-LET-type radiation effects (RBE simi
lar to 1). In contrast, decays in DNA cause pronounced high-LET-type e
ffects (RBE similar to 7-9). However, recent studies suggest that even
for DNA-associated Auger emitters cell damage can be modified to rese
mble the pattern observed with low-LET radiations. These findings indi
cate that the molecular and cellular mechanism(s) responsible for the
cytotoxic effects of Auger emitters remain obscure.