PGM files are uncompressed and greyscale only, and few everyday apps open them. PDF looks the same on every device and keeps several pages in one file. PGM is at home in greyscale images in scientific and command-line tools; PDF is the usual choice for documents that must look the same everywhere, and printing.
Add several files and you can also combine them into a single PDF. The defaults suit most files. Under Options you can choose the page size.
Pictures with more than 8 bits per channel are reduced to 8 bits when they are decoded. Each picture becomes one page. The page can match the picture's own size or be A4 or US Letter; on paper the sheet turns to suit the picture, which is shrunk to fit inside the margins and never enlarged.