Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are normal and without change . Mild tortuosity of the thoracic aorta is stable . Lungs are clear . Biapical thickening appears similar to prior study with symmetrical distribution . There is no pleural effusion . Overall , lung volumes remain increased , suggesting the possibility of COPD . Bones are diffusely demineralized , and multilevel degenerative changes are present in the spine .
    OUTPUT:
    
No radiographic evidence of pneumonia .