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New AI Tool Helps Detect Brain Aneurysms On CT Angiography Exams

By MedImaging International staff writers
Posted on 24 Jun 2019

Image: In this brain scan, the location of an aneurysm is indicated by HeadXNet using a transparent red highlight (Photo courtesy of Allison Park).

Researchers from Stanford University (Stanford, CA, USA) have developed an artificial intelligence (AI) tool that can help radiologists improve their diagnoses of brain aneurysms by highlighting the areas of a brain scan that are likely to contain an aneurysm.

To overcome the inherent challenges of complex neurovascular anatomy and potential fatal outcome of a missed aneurysm, the researchers focused on creating an AI tool that could accurately process large stacks of 3D images and complement clinical diagnostic practice. The tool is built around an algorithm called HeadXNet which was trained by outlining clinically significant aneurysms detectable on 611 computed tomography (CT) angiogram head scans. The researchers focused on its ability to identify the presence aneurysms rather than on detecting their absence.

Following the training, the algorithm decides for each voxel of a scan whether there is an aneurysm present. As a result of the HeadXNet tool, the algorithm’s conclusions overlaid as a semi-transparent highlight on top of the scan. This representation of the algorithm’s decision allows clinicians to also see what the scans look like without HeadXNet’s input. HeadXNet was tested by eight clinicians who evaluated a set of 115 brain scans for aneurysm, once with the help of HeadXNet and once without. With the tool, the clinicians correctly identified more aneurysms, thereby reducing the “miss” rate, and were more likely to agree with one another. HeadXNet did not influence the time it took for the clinicians to decide on a diagnosis or their ability to correctly identify scans without aneurysms.

“There’s been a lot of concern about how machine learning will actually work within the medical field,” said Allison Park, a Stanford graduate student in statistics and co-lead author of the paper published in JAMA Network Open. “This research is an example of how humans stay involved in the diagnostic process, aided by an artificial intelligence tool.”

HeadXNet’s success in these experiments is promising and the machine learning methods at its heart could likely be trained to identify other diseases inside and outside the brain. For example, the researchers imagine a future version could focus on speeding up identifying aneurysms after they have burst, saving precious time in an urgent situation. However, the researchers have cautioned that further investigation is needed to evaluate generalizability of the AI tool prior to real-time clinical deployment due to differences in scanner hardware and imaging protocols across different hospital centers.

“Because of these issues, I think deployment will come faster not with pure AI automation, but instead with AI and radiologists collaborating,” said Andrew Ng, adjunct professor of computer science and co-senior author of the paper who leads Stanford’s Machine Learning Group. “We still have technical and non-technical work to do, but we as a community will get there and AI-radiologist collaboration is the most promising path.”

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63 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

64 (!!!!! 9809.9708557129): 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 (831.12716674805): SELECT fid FROM jos_deeppockets WHERE id=294778408 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294778408 AND published='1' LIMIT 1

66 (285.14862060547): 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=217 ORDER BY `ordering`

67 (523.09036254883): select jos_twitters.link from jos_twitters where cat=10

68 (48.87580871582): select jos_facebook.link from jos_facebook where cat=10

69 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

70 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

71 (37.193298339844): SELECT fid FROM jos_deeppockets WHERE id=294778408 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294778408 AND published='1' LIMIT 1

72 (275.85029602051): 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=217 ORDER BY `ordering`

73 (970.12519836426): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (387.90702819824): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (62.942504882812): 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 (!!!!! 3250.1220703125): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (597.00012207031): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (108.95729064941): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (510.93101501465): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (55.789947509766): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (323.05717468262): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (147.81951904297): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (552.17742919922): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (125.88500976562): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (!!!!! 1913.7859344482): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (!!!!! 1508.9511871338): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (!!!!! 1963.8538360596): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (385.99967956543): 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 (356.19735717773): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (210.04676818848): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (174.99923706055): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (177.86026000977): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (150.91896057129): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (199.0795135498): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (!!!!! 3988.9812469482): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

108 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

109 (196.93374633789): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (829.93507385254): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (380.03921508789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

112 (479.93659973145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

113 (466.10832214355): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (609.15946960449): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (!!!!! 1145.8396911621): 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

116 (617.02728271484): 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 (663.04206848145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

118 (424.14665222168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

119 (!!!!! 6454.9446105957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

120 (!!!!! 4418.1346893311): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

121 (546.93222045898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

122 (596.04644775391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

123 (!!!!! 4364.9673461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

124 (!!!!! 7267.951965332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

125 (!!!!! 8178.9493560791): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 53684.949874878): 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 (!!!!! 1259.0885162354): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778408 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778408 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (56.982040405273): ( 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 (159.97886657715): ( 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

130 (264.16778564453): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (411.9873046875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (126.12342834473): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (378.13186645508): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (210.04676818848): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (319.9577331543): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (870.94306945801): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (553.84635925293): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (144.00482177734): SELECT name FROM jos_deeppockets WHERE id=217

141 (152.1110534668): SELECT name FROM jos_deeppockets WHERE id=217

142 (576.01928710938): 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 '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (766.03889465332): 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 '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (326.15661621094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

145 (!!!!! 4013.0615234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

146 (!!!!! 9199.857711792): TRUNCATE TABLE jos_trademed_module

147 (!!!!! 1039.0281677246): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (!!!!! 8642.1966552734): 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=294778408 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (321.86508178711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (280.85708618164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (221.96769714355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

152 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

153 (!!!!! 1360.8932495117): 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 (!!!!! 3834.0091705322): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

155 (875.23460388184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

156 (104.90417480469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778408 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778408 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (746.9654083252): 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=217 or channel_id is null)

158 (!!!!! 5467.1764373779): 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=217 or channel_id is null)

159 (!!!!! 1235.9619140625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (!!!!! 2257.1086883545): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

161 (496.14906311035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778408 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778408 AND published='1' LIMIT 1

162 (47.922134399414): select jos_twitters.link from jos_twitters where cat=10

163 (27.894973754883): select jos_facebook.link from jos_facebook where cat=10

164 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

165 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

166 (863.07525634766): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

167 (!!!!! 15847.92137146): insert into jos_banners_delta values (14202,'2025-08-04 10:53:21','216.73.216.210','view'),(14203,'2025-08-04 10:53:21','216.73.216.210','view')

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