Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior study , and allowing for technical differences , I doubt significant interval change . Low lung volumes are again present . Again seen is a tracheostomy tube , with considerable prominence the cardiomediastinal silhouette and vascular plethora . Possibility of pericardial effusion has been previously raised . Probable increased retrocardiac density , similar to the prior film , though this is likely accentuated by underpenetration . No gross effusion .
    OUTPUT:
    
Doubt significant change compared with 1 day earlier .