One type of particle emitted during radioactive decay is the gamma ray.

Gamma rays are

electromagnetic radiation given off from the nucleus in order to release excess energy.1 This
type of radiation is very penetrating and requires thick layers of concrete or steel for shielding. I
spoke with one of the physicists at my clinic who explained that the isotope Iodine-125 (I-125),
which is used in our clinic for brachytherapy of the prostate, emits gamma rays. For our
prostate patients, brachytherapy is delivered after an initial dose of 45Gy has been delivered
with external beam IMRT. How is the 125I that we use created? Our physicist further explained
that 124Xe is bombarded with neutrons, causing it to emit gamma rays and become unstable
125
Xe, which then becomes unstable 125I through electron capture. The decay of I-125 also
occurs by electron capture and produces 125Te in an excited state.2 The excited 125Te emits 35.5
keV gamma photons and 27-35 keV characteristic x-rays as it decays to ground state.2 The low
photon energy as well as its ½ life of 59.4 days makes I-125 an excellent choice for low dose
brachytherapy.2
Planning for prostate seed cases using I-125 be done in real-time in the operating room (OR) or
inversely and the seeds can be free or stranded. Our facility chooses to do real-time planning in
the OR and purchases free seeds so that any combination of seeds can be created at the time of
the procedure. However, according to Hirose et al,3 the use of stranded seeds has been shown to
reduce the incidence of seed migration and improve dose quality and distribution. The use of
brachytherapy has many advantages. For example, the number of trips a patient has to make for
their treatment is decreased when compared to radiation therapy alone. In addition,
brachytherapy also overcomes the obstacles associated with organ movement, which is common
in the treatment of prostate cancer.
1. Lenards, N. Brachytherapy: History and Review. [SoftChalk]. La Crosse, WI: UW-L Medical
Dosimetry Program; 2018.
2. Khan FM. The Physics of Radiation Therapy. 5th ed. Philadelphia, PA: Lippincott Williams &
Wilkins; 2014.
3. Hirose K, Aoki M, Sato M et al. Analysis of the relationship between prescribed dose and
dosimetric advantage of real-time intraoperatively built custom-linked seeds in iodine-125
prostate brachytherapy. Radiat Oncol. 2017;12(1):192. http://dx.doi.org/10.1186/s13014-017-
0932-7