Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph is obtained . In comparison to the prior study , the lungs are better expanded and numerous bilateral metastases are better demarcated . The diffuse pattern of opacification caused by extensive metastatic disease makes it very difficult to appreciate any overlying consolidation ; therefore pneumonia should be diagnosed clinically . Cardiomediastinal silhouette is unchanged . No pleural effusions and no pneumothorax .
    OUTPUT:
    
No significant changes compared to the prior study .