Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive bilateral scattered round , cannonball focal opacities throughout both lungs , which do not appear significantly different when compared to the scout film on ___ . The cardiomediastinal silhouette and hila are unchanged . No pleural effusion or pneumothorax . No acute osseous abnormality .
    OUTPUT:
    
Extensive bilateral metastatic pulmonary lesions , not significantly changed ___ ___ .