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AI-Supported Mammography Screening Detects 20% More Cancers and Halves Radiologist Workload

By MedImaging International staff writers
Posted on 03 Aug 2023

Mammography screening for breast cancer has been proven to enhance prognosis and lower mortality by early detection of the disease, enabling timely treatment. However, it is estimated that 20-30% of interval cancers, which should have been detected in the prior screening, are overlooked, and numerous suspicious findings often prove benign. To ensure high sensitivity, European guidelines advise having two radiologists review the mammograms, but there's a shortage of breast radiologists in many countries and it takes over a decade to train a radiologist in becoming proficient in reading mammograms.

Artificial intelligence (AI) has been suggested as a potential automated second reader for mammograms, which could lessen the radiologist’s workload and enhance screening accuracy. The technology has shown promising results in retrospective studies using AI to triage examinations to single or double reading and aiding radiologists in identifying suspicious features to reduce false negative results with the use of computer-aided detection (CAD). However, there has been very less solid evidence from prospective randomized trials to support this. Now, an interim safety analysis of the first randomized controlled trial of its kind, involving over 80,000 Swedish women, has discovered that AI-assisted mammography analysis matches the efficacy of two breast radiologists in detecting breast cancer, without an increase in false positives and reducing the screen-reading workload by nearly half.

In a study conducted by researchers at Lund University (Lund, Sweden;), 80,033 women aged 40-80 years who underwent mammogram screening at four locations in southwest Sweden from April 2021 to July 2022 were randomly assigned to either AI-supported analysis (where a commercial AI-supported mammogram reading system examined the mammograms before one or two radiologists also read them) or standard analysis carried out by two radiologists without AI support. This initial assessment of the Mammography Screening with Artificial Intelligence (MASAI) trial compared early screening performance and screen-reading workload between the two groups.

The minimum clinically acceptable limit for safety in the AI-supported group was set at a cancer detection rate exceeding three cancers per 1,000 screened women. The assumption was that the detection rate might fall as the majority of screening exams would undergo single reading instead of double reading. The baseline detection rate with double reading in the current screening program is five cancers per 1,000 screened women. In the AI-supported analysis, the AI system initially analyzed the mammography image and predicted the cancer risk on a scale from one to ten, with one being the lowest risk and 10 the highest. Images with a risk score below 10 were further analyzed by one radiologist, while images with a risk score of 10 were analyzed by two radiologists.

The system also offered CAD marks to aid radiologists in interpreting mammography images accurately. Women were recalled for further testing in case of suspicious findings. Radiologists made the final decision to recall women and were instructed to recall cases within the top 1% risk, barring clear false positives. AI failed to give a risk score in 0.8% of cases (306/39,996), which were referred to standard care (double reading). The recall rates averaged 2.2% (861 women) for AI-supported screening and 2.0% (817 women) for standard double reading without AI. These were similar to the average 2.1% recall rate in the clinic six months before the trial began, indicating that there was no decline in the cancer detection rates.

Overall, 244 women (28%) recalled from AI-supported screening were diagnosed with cancer, compared to 203 women (25%) recalled from standard screening, resulting in 41 additional cancers detected using AI. The false-positive rate was 1.5% in both groups. In general, AI-supported screening resulted in a cancer detection rate of six per 1,000 screened women compared to five per 1,000 for standard double reading without AI, equivalent to detecting one additional cancer for every 1,000 women screened. Significantly, there were 36,886 fewer screen readings by radiologists in the AI-supported group than in the control group (46,345 vs. 83,231), resulting in a 44% reduction in the radiologists' screen-reading workload.

Although the actual time saved by using AI was not measured in the trial, the researchers estimate that if a radiologist reads an average of 50 mammograms an hour, it would have taken one radiologist 4.6 months less to read the roughly 40,000 screening examinations using AI compared with the roughly 40,000 in the control arm that were double read. The MASAI trial will continue to ascertain whether AI-supported mammography screening reduces interval cancers. The final trial results determining whether the use of AI in interpreting mammography images leads to a reduction in interval cancers in 100,000 women followed over two years, and ultimately whether the use of AI in mammography screening is justified, are not expected for several years.

“The greatest potential of AI right now is that it could allow radiologists to be less burdened by the excessive amount of reading,” said lead author Dr. Kristina Lång from Lund University. “While our AI-supported screening system requires at least one radiologist in charge of detection, it could potentially do away with the need for double reading of the majority of mammograms easing the pressure on workloads and enabling radiologists to focus on more advanced diagnostics while shortening waiting times for patients.”

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57 (46.014785766602): 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'

58 (53.167343139648): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

59 (391.96014404297): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

60 (!!!!! 1010.8947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

61 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

62 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

63 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

64 (66.041946411133): 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

65 (544.07119750977): SELECT fid FROM jos_deeppockets WHERE id=294798161 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294798161 AND published='1' LIMIT 1

66 (44.822692871094): 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=211 ORDER BY `ordering`

67 (43.153762817383): select jos_twitters.link from jos_twitters where cat=10

68 (29.802322387695): select jos_facebook.link from jos_facebook where cat=10

69 (28.133392333984): select jos_google_plus.link from jos_google_plus where cat=10

70 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

71 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294798161 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294798161 AND published='1' LIMIT 1

72 (42.915344238281): 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=211 ORDER BY `ordering`

73 (401.02005004883): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (215.05355834961): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (36.954879760742): 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`

76 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (44.107437133789): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (28.848648071289): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (31.948089599609): 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`

93 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

108 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

109 (48.87580871582): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (43.869018554688): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

112 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

113 (370.02563476562): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (356.91261291504): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (50.067901611328): 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=294798158 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (394.10591125488): 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=294798158 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (550.0316619873): 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

118 (319.00405883789): 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 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

120 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

121 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

122 (33.855438232422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

123 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

124 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

125 (200.03318786621): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 39195.06072998): 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

127 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

128 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

129 (367.16461181641): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798161 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798161 AND type='deeppockets_item' AND published='1' LIMIT 1

130 (!!!!! 424787.04452515): ( 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

131 (71.048736572266): ( 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 (43.153762817383): 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

133 (28.133392333984): 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 (41.961669921875): 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

135 (27.894973754883): 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 (27.894973754883): 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

137 (27.894973754883): 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 (406.98051452637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (274.8966217041): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (36.954879760742): SELECT name FROM jos_deeppockets WHERE id=211

141 (28.133392333984): SELECT name FROM jos_deeppockets WHERE id=211

142 (452.99530029297): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (350.9521484375): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

145 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

146 (!!!!! 7408.1420898438): TRUNCATE TABLE jos_trademed_module

147 (77.009201049805): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (48.87580871582): 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=294798161 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (755.07164001465): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

152 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

153 (!!!!! 1113.1763458252): 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

154 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

155 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

156 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798161 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798161 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (30.994415283203): 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=0 or channel_id is null)

158 (26.941299438477): 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=0 or channel_id is null)

159 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (111.81831359863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

161 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798161 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798161 AND published='1' LIMIT 1

162 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

163 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

164 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

165 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

166 (272.03559875488): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

167 (!!!!! 1039.981842041): insert into jos_banners_delta values (14615,'2025-04-29 21:27:40','18.188.148.202','view'),(14202,'2025-04-29 21:27:40','18.188.148.202','view'),(14203,'2025-04-29 21:27:40','18.188.148.202','view')

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