Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and hilar contours are unchanged . Left - sided Port - A - Cath tip terminates in the low SVC . Ill - defined nodular opacities are again demonstrated most pronounced in both upper lobes compatible with metastatic disease , not substantially changed from the prior study . No new focal consolidation , pleural effusion or pneumothorax is identified . There is no pulmonary vascular congestion . Numerous clips are noted within the right axilla and anterior chest wall . Osseous metastases within the thoracic spine are better visualized on the previous CT .
    OUTPUT:
    
No radiographic evidence of pneumonia . Similar appearance of pulmonary metastases .