Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior study , moderate cardiomegaly is unchanged . No overt pulmonary edema . Unchanged positioning of the right - sided pacemaker leads . Trace bilateral pleural effusions without pneumothorax . Ribs appear somewhat sclerotic , difficult to exclude underlying metastasis . Midline sternotomy wires again noted .
    OUTPUT:
    
1 . No focal consolidation concerning for pneumonia . No overt pulmonary edema . 2 . Sclerotic appearance of the ribcage in this patient with known prostate cancer , may be due to metastatic disease .