Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable frontal chest radiograph again demonstrates heterogeneous bilateral opacities consistent with ARDS . Radiographically , there is not much change . There is no pneumothorax or large pleural effusion . The endotracheal tube , nasogastric tube , and right PICC are unchanged in position .
    OUTPUT:
    
No significant change in heterogeneous bilateral opacities . No pneumothorax or large pleural effusion .