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3D Image Guidance Tool Designed to Visualize, Target, and Treat Tumor Lesions

By MedImaging International staff writers
Posted on 26 May 2014

Image: Prof. Maleux, interventional radiologist at University Hospital Louvain (Belgium) and his team are performing an embolization procedure (Photo courtesy of Philips Healthcare).

Image: Embolization procedure with Philips EmboGuide at University Hospital Louvain (Belgium) (Photo courtesy of Philips Healthcare).

Image: EmboGuide 3D live image guidance tool to see, reach, and treat tumor lesions (Photo courtesy of Philips Healthcare).

A live three-dimensional (3D) image guidance application optimizes tumor embolization procedures on interventional X-ray systems.

Philips Healthcare (Best, The Netherlands) reported on the launch of EmboGuide, its latest technology in interventional oncology, to treat difficult-to-reach tumors or tumors in patients who are deemed unsuitable for surgery. EmboGuide is a live 3D image guidance tool that supports the increasing number of minimally invasive procedures. It is designed to be used with Philips’ interventional X-ray system to perform tumor embolization procedures. Such procedures involve blocking the arteries feeding a tumor to deprive it of nutrients and oxygen. They require the insertion of a catheter, which must be guided to the tumor site with the aid of live image-guidance.

Developed in collaboration with leading clinicians and partners such as BTG (Eclépens, Switzerland), a developer of interventional oncology systems, EmboGuide addresses the need for an enhanced 3D imaging system to make interventional oncology procedures more effective and easier to perform, and ultimately enhance patient outcomes. It provides interventional radiologists with the ability to visualize and characterize tumor lesions and plan and perform interventional procedures.

“Interventional oncology is a fast growing field that offers clinicians a viable treatment option for patients who are not suitable for surgical tumor removal,” said Gene Saragnese, CEO imaging systems at Philips Healthcare. “Together with our partners, we will leverage our combined expertise in image-guided interventions and therapies to accelerate this transformation from surgical procedures to minimally invasive treatments in oncology.”

A specific example of a tumor embolization procedure is transarterial chemo-embolization (TACE), used for palliative treatment of liver tumors. It involves simultaneous local administration of chemotherapy and beads that block the arteries feeding the liver tumor. “We can only treat what we see, yet the embolization of all blood vessels that feed the liver tumor lesion is key for an effective TACE procedure,” said Shiro Miyayama, MD, from the department of diagnostic radiology, Fukuiken Saisekai Hospital (Japan). “EmboGuide’s live 3D image guidance helps to improve the technical success of the procedure, as it can automatically identify the small tumor-feeders that are difficult to detect with conventional 2D angiographic imaging methods.”

The visualization feature of the EmboGuide utilizes the ultra-low X-ray dose settings of Philips’ AlluraClarity interventional X-ray system and the fast, high quality imaging of the abdomen of XperCT Dual. XperCT Dual’s enhanced imaging technique—multiphase cone beam CT—offers excellent 3D images of lesions, with detection accuracy that is superior to traditional 2D angiographic imaging. It offers clinicians better imaging of the treatment targets for optimized decision-making while performing the procedure. XperCT Dual has been found to be comparable to magnetic resonance imaging (MRI), which is considered to be the “gold standard.”

The reach feature of the EmboGuide helps to define the tumor lesions and features automatic identification of blood vessels that feed the lesions. It detects more than twice as many tumor feeding arteries compared to traditional imaging techniques, such as digital subtraction angiography (DSA). This allows interventional radiologists to optimize the catheter locations for embolization and plan a route to them. During the administration of the embolization agent, EmboGuide accurately superimposes the planning information onto the interventional X-ray system’s live images to monitor the treatment progress and determine its endpoint.

“In the treatment of intermediate HCC, the integrated use of our embolic device with image guidance is vital for successful treatment,” said Mike Motion, BTG general manager, interventional oncology. “As a leader in interventional oncology, we invest to improve the safety and efficacy of the procedure. Partnering with Philips has strengthened our ability to further develop this cohesive approach using DC Bead and Philips’ EmboGuide with the ultimate objective of advancing interventional oncology.”

The launch of EmboGuide is a result of Philips’ global investment in Healthcare R&D, which amounted to a total of EUR 780 million in 2013. It highlights Philips’ focus on interventional oncology—a rapidly developing market with a compound annual growth rate of approximately 15%.

Philips’ EmboGuide was presented at the Asia-Pacific Congress of Cardiovascular and Interventional Radiology (APCCVIR), held in Singapore from May 15-18, 2014. At the Congress, Dr. Miyayama shared his experiences with EmboGuide in a scientific presentation.

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60 (946.044921875): 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=294752641 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

61 (!!!!! 3671.8845367432): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

62 (369.78721618652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

63 (334.9781036377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

64 (!!!!! 1131.7729949951): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

65 (!!!!! 2682.9242706299): 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

66 (935.07766723633): SELECT fid FROM jos_deeppockets WHERE id=294752641 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294752641 AND published='1' LIMIT 1

67 (!!!!! 1528.9783477783): 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`

68 (!!!!! 1864.9101257324): select jos_twitters.link from jos_twitters where cat=10

69 (!!!!! 1310.8253479004): select jos_facebook.link from jos_facebook where cat=10

70 (689.98336791992): select jos_google_plus.link from jos_google_plus where cat=10

71 (899.7917175293): select jos_linkedin.link from jos_linkedin where cat=10

72 (!!!!! 6520.9865570068): SELECT fid FROM jos_deeppockets WHERE id=294752641 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294752641 AND published='1' LIMIT 1

73 (272.03559875488): 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`

74 (423.19297790527): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (424.86190795898): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (324.96452331543): 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`

77 (873.08883666992): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (233.88862609863): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (145.91217041016): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (185.01281738281): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (219.10667419434): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (751.01852416992): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (441.07437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (203.84788513184): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (813.00735473633): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (354.05158996582): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (211.00044250488): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (654.93583679199): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (411.03363037109): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (977.99301147461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (333.07075500488): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (650.88272094727): 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`

94 (653.02848815918): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (732.8987121582): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (796.07963562012): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 3571.9871520996): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (!!!!! 1372.0989227295): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 1006.1264038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (92.029571533203): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (249.14741516113): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (403.16581726074): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (!!!!! 3013.1340026855): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (!!!!! 1356.1248779297): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (988.96026611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

109 (!!!!! 7353.0673980713): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

110 (558.13789367676): 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=294752641 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 6937.0269775391): 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=294752641 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 7231.9507598877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

113 (!!!!! 7987.0223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

114 (!!!!! 5161.0469818115): 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=294752641 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (!!!!! 1324.8920440674): 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=294752641 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (!!!!! 7556.9152832031): 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

117 (!!!!! 7660.8657836914): 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 (!!!!! 3757.9536437988): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

119 (!!!!! 6726.0265350342): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

120 (!!!!! 7750.0343322754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

121 (!!!!! 8251.9054412842): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

122 (!!!!! 7885.9329223633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

123 (!!!!! 6341.9342041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

124 (!!!!! 3565.0730133057): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

125 (!!!!! 4190.20652771): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

126 (!!!!! 11381.864547729): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752641 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752641 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 1594110.0120544): ( 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

128 (!!!!! 2464051.0082245): ( 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

129 (265.83671569824): 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

130 (124.21607971191): 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

131 (79.870223999023): 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

132 (86.069107055664): 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

133 (72.956085205078): 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

134 (63.896179199219): 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

135 (375.98609924316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (298.02322387695): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (260.82992553711): SELECT name FROM jos_deeppockets WHERE id=211

138 (32.901763916016): SELECT name FROM jos_deeppockets WHERE id=211

139 (463.96255493164): 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

140 (349.99847412109): 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

141 (!!!!! 1026.1535644531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

142 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

143 (818.96781921387): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

144 (545.02487182617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

146 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

147 (!!!!! 1036.8824005127): 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

148 (255.82313537598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

149 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

150 (!!!!! 1802.921295166): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294752641 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294752641 AND type='deeppockets_item' AND published='1' LIMIT 1

151 (187.87384033203): 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=211 or channel_id is null)

152 (133.03756713867): 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=211 or channel_id is null)

153 (149.96528625488): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

154 (!!!!! 3098.9646911621): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

155 (164.98565673828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294752641 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294752641 AND published='1' LIMIT 1

156 (!!!!! 2937.0784759521): select jos_twitters.link from jos_twitters where cat=10

157 (36.954879760742): select jos_facebook.link from jos_facebook where cat=10

158 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

159 (31.948089599609): select jos_linkedin.link from jos_linkedin where cat=10

160 (324.01084899902): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

161 (!!!!! 3330.9459686279): insert into jos_banners_delta values (14615,'2025-04-30 06:52:53','18.222.197.224','view'),(14202,'2025-04-30 06:52:53','18.222.197.224','view'),(14203,'2025-04-30 06:52:53','18.222.197.224','view')

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