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MRI-Ultrasound Fusion-Guided Biopsy Detects Prostate Cancer

By MedImaging International staff writers
Posted on 24 Dec 2012

Cutting-edge research conducted by a group of engineers and clinicians demonstrates that prostate cancer—long detected only through hit-or-miss and painful biopsies—can be diagnosed far more easily and effectively using a new image-guided, targeted biopsy procedure.

Customarily, prostate tumors have been identified through so-called blind biopsies, in which tissue samples are gathered systematically from the entire prostate in the prospect of finding a part of a tumor--a strategy that was developed in the 1980s. But the tumor now can be detectable by direct sampling of tumor spots detected using magnetic resonance imaging (MRI), in combination with real-time ultrasound, according to the University of California, Los Angeles (UCLA; USA) researchers.

The study’s findings are published December 10, 2012, in the early online edition of the Journal of Urology and are scheduled for print publication in the journal's January 2013 issue. The UCLA study indicates that the MRI–ultrasound fusion biopsy, which is much more accurate than a conventional blind biopsy, may lead to a decrease in the number of prostate biopsies performed and could allow for the early detection of serious prostate tumors.

The study involved 171 men who were either undergoing active surveillance to monitor slow-growing prostate cancers or who, despite prior negative biopsies, had persistently elevated levels of prostate-specific antigen (PSA), a protein produced by the prostate that can indicate the presence of cancer. The UCLA biopsies using the new technique were done in about 20 minutes in an outpatient clinic environment under local anesthesia.

Yearly, almost all of the one million prostate biopsies performed in the United States are prompted by elevations in prostate-specific antigen (PSA) levels, and approximately 240,000 new instances of prostate cancer are found each year. Therefore, approximately 75% of biopsies are negative for cancer. However, many men with negative biopsies but elevated PSA levels may still harbor malignant tumors—tumors missed by traditional biopsies, according to the study’s senior author, Dr. Leonard S. Marks, a professor of urology and director of UCLA’s active surveillance program.

“Early prostate cancer is difficult to image because of the limited contrast between normal and malignant tissues within the prostate,” Dr. Marks said. “Conventional biopsies are basically performed blindly because we can’t see what we’re aiming for. Now, with this new method, which fuses MRI and ultrasound, we have the potential to see the prostate cancer and aim for it in a much more refined and rational manner.”

The new targeting process is the outcome of four years of work funded by the US National Cancer Institute and based at the Clark Urology Center at UCLA.

Since the mid-1980s, prostate cancer has been diagnosed using transrectal ultrasound to sample the prostate. Unlike most other cancers, prostate cancer is the only major malignancy diagnosed without actually visualizing the tumor as a biopsy is performed, according to Dr. Marks.

With the development of sophisticated MRI technology, the ability to image the prostate improved and provided an image of tumors within the organ. However, trying to biopsy the prostate with the patient inside an MRI scanner turned out to be costly, awkward, and time-consuming. However, with the development of the new MRI-ultrasound fusion process, the biopsy can now be performed in a clinic setting.

In the study, the volunteers first underwent MRI to visualize the prostate and any lesions. That data were then fed into a device called the Artemis, which electronically fuses the MR images with real-time, three-dimensional (3D) ultrasound, allowing the urologist to see the lesion during the biopsy. “With the Artemis, we have a virtual map of the suspicious areas placed directly onto the ultrasound image during the biopsy,” Dr. Marks said. “When you can see a lesion, you’ve got a major advantage of knowing what’s really going on in the prostate. The results have been very dramatic, and the rate of cancer detection in these targeted biopsies is very high. We’re finding a lot of tumors that hadn’t been found before using conventional biopsies.”

Prostate cancer was detected in 53% of 171 study participants. Of those tumors found using the fusion biopsy technique, 38% had a Gleason score of greater than seven, indicating an aggressive tumor and one more likely to metastasize than a tumor with lower scores. Once prostate cancer spreads, it is much more complicated to treat, and survival drops.

The UCLA study group of investigators included physicians and scientists from urology, radiology, pathology, the Center for Advanced Surgical and Interventional Technology (CASIT) and biomedical engineering. “Prostate lesions identified on MRI can be accurately targeted with MR-Ultrasound fusion biopsy in a clinic setting using local anesthesia,” the study authors stated. “Biopsy findings correlate with the level of suspicion on MRI. Targeted prostate biopsy has the potential to improve the diagnosis of prostate cancer and may aid in the selection of patients for active surveillance and focal therapy.”

The Artemis technology was developed by Eigen Corp. (Grass Valley, CA, USA).

Related Links:
University of California, Los Angeles
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59 (231.02760314941): SELECT name FROM jos_deeppockets_archive WHERE id=294743949 LIMIT 1

60 (67.949295043945): SELECT a.* FROM jos_components AS a WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' ) AND a.option = 'com_syndicate'

61 (92.983245849609): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

62 (!!!!! 11873.960494995): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

63 (!!!!! 1719.9516296387): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

64 (!!!!! 2461.1949920654): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

65 (320.9114074707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

66 (!!!!! 4343.9865112305): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

67 (473.97613525391): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

68 (607.01370239258): SELECT fid FROM jos_deeppockets WHERE id=294743949 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294743949 AND published='1' LIMIT 1

69 (!!!!! 6582.9753875732): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (!!!!! 1049.9954223633): select jos_twitters.link from jos_twitters where cat=10

71 (499.96376037598): select jos_facebook.link from jos_facebook where cat=10

72 (597.95379638672): select jos_google_plus.link from jos_google_plus where cat=10

73 (462.05520629883): select jos_linkedin.link from jos_linkedin where cat=10

74 (653.02848815918): SELECT fid FROM jos_deeppockets WHERE id=294743949 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294743949 AND published='1' LIMIT 1

75 (669.00253295898): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

76 (713.10997009277): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

77 (691.89071655273): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

78 (!!!!! 94551.801681519): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

79 (140.90538024902): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (52.213668823242): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (81.062316894531): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

94 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

95 (61.03515625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

96 (437.02125549316): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (99.897384643555): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (159.02519226074): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (93.936920166016): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (137.8059387207): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (102.99682617188): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (56.028366088867): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (97.036361694336): SELECT show_live FROM jos_com_show_setting LIMIT 1

109 (63.180923461914): SELECT show_live FROM jos_com_show_setting LIMIT 1

110 (!!!!! 1147.985458374): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

111 (127.07710266113): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

112 (149.01161193848): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (274.8966217041): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (!!!!! 1179.9335479736): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

115 (176.90658569336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

116 (184.05914306641): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (681.87713623047): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

118 (844.95544433594): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

119 (445.84274291992): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

120 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

121 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

122 (173.80714416504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

123 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

124 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

125 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

126 (304.9373626709): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

127 (!!!!! 123947.14355469): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

128 (!!!!! 4590.0344848633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

129 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

130 (598.90747070312): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743949 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743949 AND type='deeppockets_item' AND published='1' LIMIT 1

131 (!!!!! 863090.99197388): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

132 (108.00361633301): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

133 (385.04600524902): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

134 (56.982040405273): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

135 (285.86387634277): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

136 (71.048736572266): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

137 (220.06034851074): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

138 (77.962875366211): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

139 (564.0983581543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (513.79203796387): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (298.97689819336): SELECT name FROM jos_deeppockets WHERE id=212

142 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=212

143 (588.17863464355): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (509.02366638184): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

145 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

146 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

147 (!!!!! 9786.84425354): TRUNCATE TABLE jos_trademed_module

148 (100.85105895996): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (193.83430480957): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294743949 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (563.14468383789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

153 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

154 (!!!!! 1266.9563293457): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

155 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

156 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

157 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743949 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743949 AND type='deeppockets_item' AND published='1' LIMIT 1

158 (34.093856811523): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

159 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

160 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

161 (311.13624572754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

162 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743949 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743949 AND published='1' LIMIT 1

163 (161.88621520996): select jos_twitters.link from jos_twitters where cat=10

164 (39.100646972656): select jos_facebook.link from jos_facebook where cat=10

165 (34.093856811523): select jos_google_plus.link from jos_google_plus where cat=10

166 (32.901763916016): select jos_linkedin.link from jos_linkedin where cat=10

167 (329.01763916016): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

168 (!!!!! 1389.9803161621): insert into jos_banners_delta values (14615,'2025-04-29 21:42:03','3.145.70.197','view'),(14202,'2025-04-29 21:42:03','3.145.70.197','view'),(14203,'2025-04-29 21:42:03','3.145.70.197','view')

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