Agnieszka Szot

Harvard Medical School, Boston, Massachusetts, United States

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Publications (4)4.67 Total impact

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    ABSTRACT: Follicular dendritic cells (FDCs) support the survival of follicular lymphoma (FL). Tumor necrosis factor alpha (TNFalpha) is overexpressed by FL cells and is critical in the development and maintenance of FDCs. We hypothesised that TNFalpha might be an ideal therapeutic target. We treated seven patients with relapsed/refractory FL with 8 weeks of etanercept, 25 mg SC on day 1 and 4 of each week. Patients without progression received 16 additional weeks of etanercept. All patients completed at least 8 weeks of etanercept and two patients completed 24 weeks. At the 8 week evaluation five patients had SD. Of the five with SD, two progressed at 9 and 12 weeks on therapy and the remaining three progressed between 12 and 24 weeks after initiating therapy. Minimal toxicity was observed. FDG-PET imaging demonstrated decreases in standardized uptake value (SUV) following treatment with etanercept in five patients. Further studies in FL targeting the microenvironment in conjunction with standard cytotoxic therapy are warranted.
    Leukemia & lymphoma 06/2008; 49(5):902-9. · 2.61 Impact Factor
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    ABSTRACT: Store-and-forward telemedicine, using e-mail to send clinical data and digital images, offers a low-cost alternative for physicians in developing countries to obtain second opinions from specialists. To explore the potential usefulness of this technique, 91 chest X-ray images were photographed using a digital camera and a view box. Four independent readers (three radiologists and one pulmonologist) read two types of digital (JPEG and JPEG2000) and original film images and indicated their confidence in the presence of eight features known to be radiological indicators of tuberculosis (TB). The results were compared to a "gold standard" established by two different radiologists, and assessed using receiver operating characteristic (ROC) curve analysis. There was no statistical difference in the overall performance between the readings from the original films and both types of digital images. The size of JPEG2000 images was approximately 120KB, making this technique feasible for slow internet connections. Our preliminary results show the potential usefulness of this technique particularly for tuberculosis and lung disease, but further studies are required to refine its potential.
    International Journal of Medical Informatics 03/2004; 73(1):65-73. · 2.06 Impact Factor
  • Agnieszka Szot
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    ABSTRACT: HTML Purpose: To evaluate the accuracy of an image segmentation and registration method used to segment specific image items - neurovascular bundles (NVBs) - in MR images obtained before and after magnetic resonance guided brachytherapy (MRBT). Information on the location of NVBs in post-brachytherapy images can then be used for calculation of the radiation dose to NVBs. Methods and Materials: The images used in this study were of 19 patients diagnosed with localized prostate cancer between November 1997 and January 2000. All patients underwent MRBT at Brigham and Women's Hospital. The sequences used were: pre-brachytherapy endorectal coil (erMR) T1 and T2-weighted fast spin echo (T2 FSE), 5000/105 TR/ETE, 10 cm FOV, 3mm contiguous axial, and post-brachytherapy phased array T2 FSE, 4000/105 TR/ETE, 14 cm FOV, 4 mm thick, 1mm spaced axial. Pre-brachytherapy T1 images were used for a manual delineation of total gland (TG) and NVBs using 3D-Slicer. T2 images were used to guide contouring of the TG, which is not well visualized in T1 images. Post-brachytherapy axial T2 weighted images were used for manual segmentation of TG. Pre and post-brachytherapy images were then co-registered using a deformable modeling technique based on finite elements in combination with thin-plate splines. The effectiveness of the registration method was evaluated by calculating prostate gland volumes before and after image registration. Radiologist assessed the accuracy of location of NVBs on post-brachytherapy images. Results: The average difference between the pre-brachytherapy prostate volume and the volume of the registered post-brachytherapy prostate was 4%. In 16 of 19 (84%) of cases, the location of the registered NVBs was in agreement with known anatomic location according to a trained radiologist. Conclusion: The registration algorithm is sufficiently accurate to assess the location of NVBs on post-brachytherapy MR images. The presented registration method provides a basis for the assessment of radiation dose to NVBs and could also be used for dose planning when using imaging methods in which the NVBs are not visible (e.g. CT). (This work was supported by NIH grant R01-AG-19513.)
    Radiological Society of North America 2003 Scientific Assembly and Annual Meeting; 12/2003
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