Precisely Translating Computed Tomography Diagnosis Accuracy into Therapeutic Intervention by a Carbon-Iodine Conjugated Polymer

Abstract The boomed development of precision medicine has underlined an immense need for ultraefficient, multifunctional markers to bridge diagnostic and therapeutic procedures. Particularly, ultraefficient X-ray computed tomography (CT) contrast agents that can precisely translate diagnostic findings into optimal therapeutic intervention represents an unsurmountable clinical challenge. Here, poly(diiododiacetylene) (PIDA), a conjugated polymer composed of only carbon and iodine atoms, is reported as an ultraefficient CT contrast agent to bridge CT diagnostic imaging with therapeutic intervention. PIDA has an unusually high iodine payload (>84 wt%), and the aggregation of nanofibrous PIDA can further amplify CT intensity for over 10 folds with improved geometrical and positional stability in vivo. Moreover, with a highly conjugated backbone, PIDA is in deep blue color, making it dually visible by both CT imaging and naked eyes. The supreme performance of PIDA in CT-guided preoperative planning and visualization-guided surgery has been validated on orthotopic xenograft rat models. More strikingly, PIDA excels clinical fiducial markers of imaging-guided radiotherapy in efficiency and biocompatibility, and exhibits successful guidance of robotic radiotherapy on Beagles, demonstrating great clinical potential to translate CT diagnosis accuracy into therapeutic intervention for precision medicine.