Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Hyperinflation is unchanged and suggestive of emphysema . There is no pleural effusion , focal consolidation , or pneumothorax . The cardiomediastinal silhouette is within normal limits . There is no suspicious pulmonary nodule . Multilevel degenerative changes of the thoracic spine are moderate and unchanged .
    OUTPUT:
    
1 . No evidence of acute cardiopulmonary process . 2 . No radiographic evidence of metastatic disease . 3 . Unchanged hyperexpansion suggesting emphysema .