The primary disadvantage of performing chest images with the AP projection rather than the PA is:
distortion of the bony thorax
increased radiation dose to the lungs
increased technical settings for the patient
increased magnification of the heart
increased magnification of the heart
Rationale: Imaging chests with the PA projection is preferred as it positions the heart closer to the image receptor, reducing magnification. Heart size is certainly of importance and is included in radiologist dictation report.
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