Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Chronic emphysematous changes are not significantly changed . Multiple small nodules measuring up to 8 mm are present predominantly in the upper lobes . Some appear to have slightly increased in size . There is no pneumonia , pulmonary edema , pleural effusion , or pneumothorax . The cardiomediastinal silhouette is normal .
    OUTPUT:
    
Multiple small pulmonary nodules , some of which appears slightly increased in size . Given the patient 's significant risk factors , recommend a noncontrast CT of the chest for further evaluation . Results were entered into the online critical results communication dashboard on ___ by Dr . ___ .