Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The inspiratory lung volumes are decreased from the prior study with resultant accentuation of the cardiac mediastinal silhouette , which is likely unchanged . The thoracic aorta is moderately tortuous . A known large hiatal hernia is unchanged . There is no large focal consolidation , pleural effusion or pneumothorax . No acute osseous abnormality is detected . There is scoliosis and hypertrophic changes of the spine .
    OUTPUT:
    
Decreased lung volumes without acute cardiopulmonary process . Unchanged large hiatal hernia .