Schematic illustration of theranostic ZnO2 NPs for MRI and enhanced oxidative stress-based cancer therapy. Upon endocytosis by tumor cells, ZnO2 NPs undergo dissociation in response to mild acidic pH, causing the release of H2O2 and Zn2+. The exogenously released H2O2 and Zn2+, that can increase the production of mitochondrial O2·- and H2O2 by inhibiting the electron transport chain (ETC), act synergistically to promote cancer cell killing through the cooperation of endogenous and exogenous ROS. Moreover, Mn-doping via partial cation exchange imparts ZnO2 NPs with pH-activated MRI contrast ability.