Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Multiple right and left apical focal opacities correlate with lung parenchymal scarring seen on ___ chest CT . Severe emphysematous changes are noted in bilateral mid lung regions . There are no visible micro or macro nodules within the lung parenchyma . The hilar , cardiomediastinal , and pleural surfaces are normal . There are no acute bony abnormalities nor fracture .
    OUTPUT:
    
1 . Biapical lung parenchymal scarring correlate with findings seen on ___ chest CT . However , please refer to ___ chest CT for further characterization of these apical findings . 2 . At the limited resolution of plain radiograph , there are no lung parenchymal nor skeletal lesions concerning for metastasis disease . Please refer to ___ chest CT for better evaluation of metastatic lesions . 3 . Severe emphysema .