Tomographic imaging of microvasculature with a purpose-designed, polymeric X-ray contrast agent

Imaging of microvasculature is primarily performed with X-ray contrast agents, owing to the wide availability of absorption-contrast laboratory source mu CT compared to phase contrast capable devices. Standard commercial contrast agents used in angiography are not suitable for high-resolution imaging ex vivo, however, as they are small molecular compounds capable of diffusing through blood vessel walls within minutes. Large nanoparticle-based blood pool contrast agents on the other hand exhibit problems with aggregation, resulting in clogging in the smallest blood vessels. Injection with solidifying plastic resins has, therefore, remained the gold standard for microvascular imaging, despite the considerable amount of training and optimization needed to properly perfuse the viscous compounds. Even with optimization, frequent gas and water inclusions commonly result in interrupted vessel segments. This lack of suitable compounds has led us to develop the polymeric, cross-linkable X-ray contrast agent XlinCA. As a water-soluble organic molecule, aggregation and inclusions are inherently avoided. High molecular weight allows it to be retained even in the highly fenestrated vasculature of the kidney filtration system. It can be covalently crosslinked using the same aldehydes used in tissue fixation protocols, leading to stable and permanent contrast. These properties allowed us to image whole mice and individual organs in 6 to 12-month-old C57BL/6J mice without requiring lengthy optimizations of injection rates and pressures, while at the same time achieving greatly improved filling of the vasculature compared to resin-based vascular casting. This work aims at illuminating the rationales, processes and challenges involved in creating this recently developed contrast agent.