Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy tube is present . The tip of the right PICC line projects over the superior cavoatrial junction . Unchanged appearance of the lung parenchyma . No pleural effusion or pneumothorax identified . The size of the cardiac silhouette is within normal limits . Calcification of the aortic arch is again noted .
    OUTPUT:
    
No significant interval change since the prior exam .