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Many methods have been described to reduce the dose delivered by diagnostic imaging examinations. In particular, previous workers have recommended a posteroanterior projection (PA) as opposed to an antero-posterior projection (AP) as a means of reducing dose. The aim of this study was to investigate the advantages of a PA projection of the abdomen over an AP projection in terms of patient dose reduction and image quality. The entrance surface dose (ESD) and dose to the ovaries and uterus within an anthropomorphic phantom, and the ESD and effective organ dose for female patients were assessed for both projections. The resultant image quality was objectively compared using European Guidelines on quality criteria. In the phantom study, statistically significant reductions of 68% (P = 0.0001) and 50% (P = 0.0014) were noted in the doses corresponding to the ovaries and uterus, respectively, while a 31% (P = 0.0182) and a 56% (P = 0.0006) reduction was noted in the ESD and the effective dose with the patient. No difference in overall image quality was seen between the two techniques. A PA projection of the abdomen is, therefore, recommended as a simple but effective method of patient dose reduction with no deterioration in image quality.

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