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Hyperpolarized <jats:sup>129<\/jats:sup>Xe MRI directly images pulmonary gas distribution but requires specialized hardware. Conventional <jats:sup>1<\/jats:sup>H MRI acquisitions can also provide functional maps using free\u2010breathing approaches. The purpose of this study is to evaluate regional ventilation derived from 3D ultrashort echo\u2010time (UTE) <jats:sup>1<\/jats:sup>H MRI using Motion\u2010Compensated Low\u2010Rank constrained reconstruction (MoCoLoR), by comparing against <jats:sup>129<\/jats:sup>Xe MRI and pulmonary function testing as reference\u2010standard. The study is retrospective in design. The study included 57 participants (25.4\u2009\u00b1\u200915.8\u2009years, 35 males and 22 females): 12 healthy volunteers, 20 pediatric, and 25 adult people with cystic fibrosis (CF) scanned between January 2022 and February 2023. Field strength\/sequence: 3T; <jats:sup>129<\/jats:sup>Xe: 2D multislice spoiled gradient\u2010recalled sequence; UTE <jats:sup>1<\/jats:sup>H: variable\u2010density 3D radial sequence. K\u2010means\u2010based <jats:sup>129<\/jats:sup>Xe ventilation defect percent (VDP), forced expiratory volume in 1\u2009s (FEV<jats:sub>1<\/jats:sub>), and lung clearance index (LCI) were evaluated against UTE <jats:sup>1<\/jats:sup>H VDP from a modified k\u2010means method. The correspondence of ventilation defect maps from <jats:sup>129<\/jats:sup>Xe and UTE <jats:sup>1<\/jats:sup>H was also evaluated. Statistical tests included the Pearson correlation coefficient (<jats:italic>r<\/jats:italic>) and <jats:italic>t<\/jats:italic> tests, with <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 considered significant. <jats:sup>129<\/jats:sup>Xe and UTE <jats:sup>1<\/jats:sup>H VDP were significantly correlated (<jats:italic>r<\/jats:italic>\u2009=\u20090.64, <jats:italic>p<\/jats:italic>\u2009=\u2009). Bland\u2013Altman analysis showed a bias of \u22120.05 (<jats:italic>p<\/jats:italic>\u2009=\u2009) and limits of agreement of (0.07, \u22120.17). The Dice spatial accuracy of the UTE\u2010based ventilation defect regions using <jats:sup>129<\/jats:sup>Xe as reference was 0.64\u2009\u00b1\u20090.05. UTE <jats:sup>1<\/jats:sup>H VDP was significantly correlated with FEV<jats:sub>1<\/jats:sub> (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.54, <jats:italic>p<\/jats:italic>\u2009=\u2009) and LCI (<jats:italic>r<\/jats:italic>\u2009=\u20090.48, <jats:italic>p<\/jats:italic>\u2009=\u2009) and was significantly different between healthy and CF participants (<jats:italic>p<\/jats:italic>\u2009=\u20090.017), although the correlations and differences were stronger for <jats:sup>129<\/jats:sup>Xe VDP. UTE <jats:sup>1<\/jats:sup>H VDP correlated with <jats:sup>129<\/jats:sup>Xe VDP, FEV<jats:sub>1<\/jats:sub>, and LCI, and demonstrated high, consistent Dice spatial accuracy against <jats:sup>129<\/jats:sup>Xe VDP. UTE <jats:sup>1<\/jats:sup>H VDP captured variations in lung ventilation and has the advantage that it can be widely implemented on any MR system for evaluation and monitoring of patients with lung disease.<\/jats:p>","DOI":"10.1002\/nbm.70033","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:35:01Z","timestamp":1744763701000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Three\u2010Dimensional Free\u2010Breathing Ultrashort Echo Time (UTE) <sup>1<\/sup>H MRI Regional Ventilation: Comparison With Hyperpolarized <sup>129<\/sup>Xe MRI and Pulmonary Function Testing in Healthy Volunteers and People With Cystic Fibrosis"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-631X","authenticated-orcid":false,"given":"Fei","family":"Tan","sequence":"first","affiliation":[{"name":"UC Berkeley\u2013UCSF Graduate Program in Bioengineering University of California, Berkeley  Berkeley California USA"},{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel\u00a0L.","family":"Eddy","sequence":"additional","affiliation":[{"name":"BC Children's Hospital Research Institute  Vancouver Canada"},{"name":"Centre for Heart Lung Innovation University of British Columbia  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa\u00a0M.","family":"Diamond","sequence":"additional","affiliation":[{"name":"BC Children's Hospital Research Institute  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan\u00a0H.","family":"Rayment","sequence":"additional","affiliation":[{"name":"BC Children's Hospital Research Institute  Vancouver Canada"},{"name":"Department of Pediatrics University of British Columbia  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4183-3634","authenticated-orcid":false,"given":"Peder\u00a0E.\u00a0Z.","family":"Larson","sequence":"additional","affiliation":[{"name":"UC Berkeley\u2013UCSF Graduate Program in Bioengineering University of California, Berkeley  Berkeley California USA"},{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"\u201cThe Top 10 Causes of Death \u201dhttps:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/the\u2010top\u201010\u2010causes\u2010of\u2010death. 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