Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal and hilar contours are unremarkable . Lungs are hyperinflated with flattening of the diaphragms and attenuation of the pulmonary vascular markings towards the apices compatible with emphysema . ___ fiducial markers are noted within the left upper lobe laterally with adjacent opacity compatible with radiation fibrosis with pleural thickening . Previously demonstrated adjacent parenchymal lesions concerning for tumor recurrence within the region of treatment in the left upper lobe are better delineated on the previous CT and PET - CT . No new areas of focal consolidation are present . No pleural effusion or pneumothorax is seen . There are no acute osseous abnormalities , with remote left - sided rib fracture again seen .
    OUTPUT:
    
Posttreatment changes in the left upper lobe . Adjacent lesions within the left upper lobe concerning for tumor recurrence are better assessed on prior PET - CT and chest CT . No new areas of focal consolidation are identified to suggest pneumonia .