Different value in Imager Pixel Spacing (0018,1164)

We are trying to incorporate a DR long length imaging (DX images) of AP and Lateral whole lower limb to be reconstructed into a Zimmer 3D processor. This processor requires the DX image’s Imager Pixel Spacing value (0018,1164).
Question: Is it normal for the same patient DX images, the AP and Lateral to be having a different Imager Pixel Spacing value (0018,1164) ? And what would cause the values to be different between AP and Lateral images?

Thanks :slight_smile: