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Artificial Intelligence Predicts Treatment Success for Melanoma Patients from Early CT Scans

By MedImaging International staff writers
Posted on 08 Mar 2022

Image: Researchers are using AI to examine CT scans of melanoma patients (Photo courtesy of Columbia University)

Artificial intelligence (AI) is poised to revolutionize the field of radiology as a tool to improve disease detection, diagnosis, and clinical care. The technology has the potential to assist clinicians by uncovering hidden information within imaging scans invisible to even the well-trained eye. Now, researchers have demonstrated that applying AI to standard-of-care imaging can help predict how well immunotherapy will work for patients with melanoma.

Researchers at Columbia University (New York, NY, USA) have developed a machine learning algorithm that analyzes a patient’s computed tomography (CT) scans and creates a biomarker – known as a radiomic signature – that correlates with patient outcome. The signature used specific features of the tumor to determine with high accuracy whether a given individual’s disease would respond well to immunotherapy, remain stable, or continue to progress. The goal of immunotherapy, which has become a primary treatment for melanoma, is to stimulate a patient’s own immune system to fight cancer.

Currently, clinicians rely almost entirely on tumor size to estimate the benefit of a therapy. Patients receive a baseline CT scan and then subsequent follow-up scans after treatment has begun. If the tumor shrinks, the treatment seems to be working, while growth implies that the patient’s disease is getting worse. But this is not necessarily the case with immunotherapy, and studies have shown that tumor size and growth does not always correlate with overall survival.

Biologically, tumors may evolve throughout the course of a patient’s disease in ways that are more complex than a measure of size alone can reflect. As an example of this, the researchers found that their machine learning algorithm worked best when it took not only tumor volume and growth into account, but also tumor spatial heterogeneity, or the non-uniform distribution of cancer cells across disease sites, and texture, which looks at the variation of pixel intensities across the tumor CT image.

The researchers validated the algorithm on data from 287 patients with advanced melanoma who were administered the immunotherapy drug pembrolizumab. The radiomic signature, which used CT images obtained at baseline and three-month follow-up was able to estimate overall survival at six months with a high degree of accuracy. In fact, it outperformed the standard method based on tumor diameter, known as Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1), which is commonly used in clinical trials to assess treatment efficacy.

The researchers now aim to expand the project to a variety of different tumor types - such as lung cancer, colon cancer, renal cancer, and prostate cancer - as well as other treatments beyond immunotherapy. The researchers wanted to start with a novel therapy and chose melanoma because of the recent, rapid adoption of immunotherapy for the disease.

“We hope to take a patient early on who looks like they are not doing well on a given therapy because of their signature and enhance, change, or add another drug to the therapy,” said Lawrence H. Schwartz, MD, the James Picker Professor and chair of the Department of Radiology at Columbia University Vagelos College of Physicians and Surgeons (VP&S).

“The field of radiology and imaging in general has never been more exciting with this artificial intelligence revolution,” added Dr. Schwartz. “We’ve always looked at advances in terms of new machines, new tracers, and things like this. But this gives us an opportunity to optimize the information that we have from all of our imaging modalities to speed diagnosis, to become more accurate and precise, and give patients more effective treatments.”

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65 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10

68 (280.14183044434): SELECT fid FROM jos_deeppockets WHERE id=294791896 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294791896 AND published='1' LIMIT 1

69 (37.908554077148): 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=215 ORDER BY `ordering`

70 (901.22222900391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (248.19374084473): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 2944.9462890625): 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`

73 (!!!!! 2429.0084838867): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (157.11784362793): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (185.01281738281): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (141.85905456543): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (160.21728515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (80.108642578125): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (117.77877807617): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (301.83792114258): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (687.1223449707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.007995605469): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.007995605469): 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`

90 (627.99453735352): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (151.8726348877): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (478.98292541504): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (188.11225891113): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (120.87821960449): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (212.9077911377): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (96.08268737793): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (132.08389282227): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (79.870223999023): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (600.09956359863): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1998.9013671875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

105 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

106 (314.95094299316): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1385.9272003174): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1008.0337524414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

109 (521.89826965332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

110 (83.92333984375): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 1046.895980835): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (701.904296875): 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

113 (484.94338989258): 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

114 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

115 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

116 (134.94491577148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

117 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

118 (163.07830810547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

119 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

120 (407.93418884277): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 56804.895401001): 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

122 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

123 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

124 (432.96813964844): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791896 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791896 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 512212.99171448): ( 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

126 (!!!!! 1039283.99086): ( 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

127 (94.175338745117): 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

128 (41.007995605469): 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

129 (44.107437133789): 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

130 (36.001205444336): 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

131 (34.809112548828): 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

132 (36.954879760742): 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

133 (427.9613494873): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (338.07754516602): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (138.99803161621): SELECT name FROM jos_deeppockets WHERE id=215

136 (72.956085205078): SELECT name FROM jos_deeppockets WHERE id=215

137 (547.88589477539): 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 '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (512.12310791016): 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 '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1313.2095336914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

140 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

141 (!!!!! 6649.0173339844): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 3194.0937042236): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (606.06002807617): 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=294791896 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (287.05596923828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

147 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

148 (!!!!! 1003.0269622803): 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

149 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

150 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

151 (373.12507629395): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791896 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791896 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (50.067901611328): 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=215 or channel_id is null)

153 (27.894973754883): 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=215 or channel_id is null)

154 (28.133392333984): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3129.9591064453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

156 (52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791896 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791896 AND published='1' LIMIT 1

157 (49.114227294922): select jos_twitters.link from jos_twitters where cat=10

158 (25.98762512207): select jos_facebook.link from jos_facebook where cat=10

159 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

160 (26.226043701172): select jos_linkedin.link from jos_linkedin where cat=10

161 (397.92060852051): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 10576.963424683): insert into jos_banners_delta values (14615,'2025-05-02 15:02:52','3.149.239.180','view'),(14202,'2025-05-02 15:02:52','3.149.239.180','view'),(14203,'2025-05-02 15:02:52','3.149.239.180','view')

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