Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right chest wall power injectable Port - A - Cath is present , the tip extending into the right atrium . Low bilateral lung volumes . Nodularity again is noted to project over both hemithoraces in keeping with the patient 's known metastatic disease . No pleural effusion or pneumothorax identified . The size and appearance of the cardiomediastinal silhouette is unchanged . Orthopedic spinal hardware projects over the cervical and upper thoracic spines .
    OUTPUT:
    
No significant interval change since the prior examination .