Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are normal . Multiple lung nodules are again noted consistent metastasis , comparison is limited due to difference in technique . There is no pneumothorax . Small right effusion is a stable . There are moderate degenerative changes in the thoracic spine
    OUTPUT:
    
No acute cardiopulmonary abnormalities . Lung nodules consistent with metastasis better seen in prior CT