Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The central line is unchanged . The multiple sclerotic bone lesions compatible with metastatic disease are again seen . The heart size is moderately enlarged . There is pulmonary vascularity redistribution and ill - defined vascularity compatible with CHF . There are patchy alveolar infiltrates bilaterally lower lobe greater than upper lobe . It is unclear if this is due to pulmonary edema or an infectious etiology .
    OUTPUT:
    
Compared to the prior study of pulmonary status is worsened . It is unclear if this is all due to pulmonary edema or there is an underlying infectious etiology .