We report the analysis of a reducing-agent-free synthetic method based on intense X-ray irradiation in the presence of 11-mercaptoundecanoic acid (MUA) and their application in biomedical imaging. The method is very effective in controlling the size and size distribution of Au nanoparticles in colloidal solutions: gold nanoparticles (AuNPs) as small as similar to 1.2 +/- 0.25 nm are synthesized in a one-pot irradiation procedure without reducing agents. We found two coexisting properties of these small AuNPs: a strong visible fluorescence and very high accumulation in cells, which enabled a new type of multimodality imaging using X-ray and visible light microscopies. These properties come as a direct consequence of the precise size control; specifically, they exist only when the particle size is smaller than similar to 1.4 nm. We found that this process critically depends on several parameters including the solution pH, the solution temperature and the irradiation time. Most important is the fact that the increase of the irradiation time is not necessarily beneficial, since an optimum value exists to obtain small particles with a narrow size distribution. The 1.4 nm AuNPs are not toxic and significantly accumulate in tumor tissues in animal tests, as confirmed by X-ray imaging and fluorescence microscopy. This biodistribution could open the way for the use of these nanoparticles in X-ray imaging.