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Using PREFUL, regional ventilation (RVent) maps were calculated from the free\u2010breathing data. Ventilation defect percentage (VDP) was determined from 3D and 2D RVent maps (2D VDP<jats:sub>RVent<\/jats:sub> and 3D VDP<jats:sub>RVent<\/jats:sub>, respectively) and Xe\u2010MRI ventilation (VDP<jats:sub>Xe<\/jats:sub>). VDP was calculated for the whole lung and for eight regions based on left\/right, anterior\/posterior, and superior\/inferior divisions of the lung. Global and regional VDP was compared between the three methods using Bland\u2013Altman analysis, linear mixed model\u2010based correlation, and one\u2010way analysis of variance and multiple comparisons tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Global 3D VDP<jats:sub>RVent<\/jats:sub>, VDP<jats:sub>Xe<\/jats:sub>, and 2D VDP<jats:sub>RVent<\/jats:sub> were all strongly correlated (all <jats:italic>R<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup> &gt; 0.62, <jats:italic>p<\/jats:italic> &lt;\u20090.0001) and showed minimal, non\u2010significant bias (all &lt;2%, <jats:italic>p<\/jats:italic> &gt; 0.05). Three dimensional and 2D VDP<jats:sub>RVent<\/jats:sub> significantly correlated to VDP<jats:sub>Xe<\/jats:sub> in most of the separate lung regions (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.18\u20130.74, <jats:italic>p<\/jats:italic> &lt;\u20090.04), but showed lower inter\u2010agreement. The superior\/anterior lung regions showed the least agreement between all three methods (all <jats:italic>p<\/jats:italic> &gt; 0.12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Absolute VDP assessed by 3D UTE PREFUL MRI showed good global agreement with Xe\u2010MRI and 2D multi\u2010slice PREFUL MRI in pediatric CF lung disease. Therefore, 3D UTE PREFUL MRI offers a sensitive and potentially more accessible alternative to Xe\u2010MRI for regional volumetric evaluation of ventilation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mrm.30299","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:20:24Z","timestamp":1726593624000},"page":"775-787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of 3D UTE free\u2010breathing lung MRI with hyperpolarized <sup>129<\/sup>Xe MRI in pediatric cystic fibrosis"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5948-6234","authenticated-orcid":false,"given":"Samal","family":"Munidasa","sequence":"first","affiliation":[{"name":"Translational Medicine Program The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Medical Biophysics University of Toronto  Toronto Ontario 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