Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size remains mild to moderately enlarged . The mediastinal contour is unchanged with a right paratracheal mediastinal fiducial clip again noted with adjacent post - treatment changes . The lungs are hyperinflated with flattening of the diaphragms compatible with COPD . The pulmonary vascularity is normal and the lungs are clear without focal consolidation . No pleural effusion or pneumothorax is seen . Multilevel degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
No radiographic evidence for pneumonia .