Sufficient penetration has been obtained on a pa chest projection when the thoracic vertebrae and posterior ribs are demonstrated through the heart and mediastinal structures. A well-penetrated chest X-ray is one where the vertebrae are just visible behind the heart. Although X-rays are still occasionally over or under-exposed, a discussion of penetration now serves as an excellent reminder to check behind the heart.
Sufficient Penetration is the degree to which X-rays have passed through the body. Assessment of penetration is traditionally a standard part of assuring chest X-ray quality. With modern digital viewing systems, over or under-penetrated images are rarely a problem. Image data can be 'windowed' to optimize the visibility of anatomical structures.
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