Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Biapical scarring is again noted . The lungs are otherwise clear without consolidation , effusion , or pulmonary vascular congestion . Cardiomediastinal silhouette is stable . Hiatal hernia is again noted . No acute osseous abnormality is detected .
    OUTPUT:
    
No acute cardiothoracic process .