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CSI additionally permits mapping spectral parameters like linewidths, enabling more accurate, regional estimation of . Moreover, regionally mapping the\n                    <jats:sup>129<\/jats:sup>\n                    Xe chemical shift in red blood cells (RBCs) offers a novel means to assess arteriolar pathology through local measurements of blood oxygenation. However, such CSI\u2010based mapping requires standardized acquisition and processing workflows along with well\u2010defined healthy reference distributions to enable robust quantification of patterns reflecting normal physiology. To this end, we implemented a fast, elliptically sampled Cartesian\n                    <jats:sup>129<\/jats:sup>\n                    Xe CSI acquisition at 3\u2009T, exciting the dissolved resonances at 208\u2009ppm. We used simulations to determine the optimal k\u2010space filter and minimum SNR for reliable spectral fitting. This approach was applied in a cohort of healthy 18\u201330\u2010year\u2010olds (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200911) to establish healthy reference distributions for quantitative mapping of RBC and membrane , RBC chemical shift, and the RBC:Membrane signal ratio. CSI reference mean values ( standard deviation after Box\u2013Cox transform) for membrane and RBC  were 1.07\u2009ms (0.97\u20131.17\u2009ms) and 1.13\u2009ms (1.05\u20131.22\u2009ms), respectively, with an RBC shift of 217.9\u2009ppm (217.2\u2013218.5\u2009ppm), and RBC:Membrane of 0.44 (0.37\u20130.54). CSI\u2010derived mean values were all significantly different from those measured by whole\u2010lung spectroscopy (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u20090.02). Notably, RBC:Membrane and membrane  increased significantly from the gravitationally non\u2010dependent to dependent lung regions, while isogravitational heterogeneity of RBC  and RBC shift decreased. Conversely, in a preliminary cohort of pulmonary hypertension (PH) patients (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20094), RBC shift heterogeneity was elevated, even in gravitationally dependent lung, although significance was not reached in this small sample (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.07). These results demonstrate how standardized quantitative\n                    <jats:sup>129<\/jats:sup>\n                    Xe CSI facilitates rigorous characterization of cardiopulmonary disease signatures and, specifically, highlight RBC shift heterogeneity as a promising marker of PH.\n                  <\/jats:p>","DOI":"10.1002\/nbm.70388","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:06:41Z","timestamp":1788412001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Standardized Spectral Mapping With\n                    <sup>129<\/sup>\n                    Xe Chemical Shift Imaging: Investigating Red Blood Cell Shift Heterogeneity in Pulmonary Hypertension"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-6188","authenticated-orcid":false,"given":"Anna","family":"Costelle","sequence":"first","affiliation":[{"name":"Medical Physics Graduate Program Duke University  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6198-3301","authenticated-orcid":false,"given":"Suphachart","family":"Leewiwatwong","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Graduate Program Duke University  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"John P.","family":"Mugler","sequence":"additional","affiliation":[{"name":"Radiology and Medical Imaging, School of Medicine University of Virginia  Charlottesville USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-109X","authenticated-orcid":false,"given":"David","family":"Mummy","sequence":"additional","affiliation":[{"name":"Department of Radiology Duke University  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3443-5040","authenticated-orcid":false,"given":"Sudarshan","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Cardiology Duke University Medical Center  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1236-4210","authenticated-orcid":false,"given":"Bastiaan","family":"Driehuys","sequence":"additional","affiliation":[{"name":"Medical Physics Graduate Program Duke University  Durham USA"},{"name":"Biomedical Engineering Graduate Program Duke University  Durham USA"},{"name":"Department of Radiology Duke University  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.25675"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnmrs.2020.11.002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1011912107"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24181"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010022\u201009343\u20109"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016152299"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010024\u201010800\u2010w"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00831\u20102019"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.02.009"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202501\u2010028OC"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2025.05.013"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102017\u2010210070"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","unstructured":"A.Swaminathan D.Mummy S.Zhang et\u00a0al. \u201cDynamic Changes in Hyperpolarized 129Xe MRI Measures After Initiation of Therapy in Patients With Idiopathic Pulmonary Fibrosis Associate With Lung Function \u201d In: American Thoracic Society International Conference. Washington D.C. 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