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Breast MRI Reveals It's Not the Size of the Lymph Node that Indicates Metastasis

By MedImaging International staff writers
Posted on 06 Jul 2009

According to new imaging research, it is not the size of the node or enhancement, but the loss of a significant part of a normal node's structure, called the fatty hilum, that more accurately signals the spread of disease.

Physicians treating breast cancer first look to lymph nodes in a patient's armpit to see whether cancer is spreading elsewhere in the body--but they may not be assessing the nodes in the most effective manner. Initial studies suggested that enlargement and abnormalities of axillary sentinel lymph nodes--located in the armpit area near the breast--were predictive of cancer.

Researchers from the University of Florida (UF) Shands Cancer Center (Gainesville, USA) published their findings online in June 2009 in the Journal of Magnetic Resonance Imaging. In addition to changing views about what clinicians should look for while evaluating lymph nodes, the finding reinforces the value of using MRI [magnetic resonance imaging] to determine the extent of breast cancer prior to surgery. "We found that the loss of fatty hilum in an axillary lymph node on MRI correlated with finding the spread of breast cancer in axillary nodes at the time of surgery,” said Stephen Grobmyer, M.D., an assistant professor of surgical oncology and endocrine surgery at the UF College of Medicine, who noted that not all nodes without fatty hilum necessarily had cancer.

The UF study retrospectively examined 56 female patients ranging in age from 30 to 82. All women had a sentinel lymph node biopsy. Fifteen women had cancer in the nodes that required complete removal. Four of eight patients in whom a loss of fatty hilum was seen in an axillary node on MRI were found to have cancerous lymph nodes at the time of their breast surgery. By comparison, only 11 out of 48 patients (23%), with all fatty hilum in place had cancer.

Dr. Grobmyer noted that these findings provide surgeons with another tool to help customize medicine and evaluate factors that could indicate whether cancer has spread prior to surgery. "I think this is another step to understanding how we can use MRI to improve care of breast cancer patients,” said Dr. Grobmyer, medical director of the UF Comprehensive Breast Center. "We are just suggesting that there may be information that people have not yet paid attention to that may impact our understanding of the staging of a patient's disease. With this technology, if you look and see there is a node or several nodes with no fatty hilum, one would be very suspicious that there might be metastatic disease present. Instead of doing an invasive sentinel node biopsy, one could do a less invasive image-guided biopsy to obtain important staging information.”

Dr. Grobmyer added it is also important that we now understand that MRI features that suggest cancer in the breast do not apply for evaluating disease in axillary lymph nodes. Currently, there is no standard MRI criterion for determining if cancer is in the nodes.

Although not routinely administered to all breast cancer patients, MRI can offer a detailed image of the breast, providing precise details about breast cancer locations and size. The scan is augmented through a technique known as contrast enhancement, which makes it easier to discern between cancerous and healthy tissue. The standard scan includes the axillary lymph nodes, the most common first site of spread for breast cancer.

Steven E. Harms, M.D., a radiologist with the Breast Center of Northwest Arkansas (Fayetteville, USA), noted that the accurate diagnosis of lymph node metastases is crucial for patients with breast cancer, and the ability to determine their presence before the initial surgery could spare many patients the need for more than one operation. "Over-treatment with a full axillary node removal is associated with a high incidence of lymphedema, a lifelong and often debilitating condition resulting from the disruption of lymph channels,” said Dr. Harms, who, in 2007, helped to draft the American Cancer Society breast cancer screening guidelines which recommend breast MRI screening for high-risk patients.

Dr. Grobmyer reported that he hopes studies of a larger number of patients will additionally confirm these findings so they can be broadly applied. He said the great advantage of an MRI is its ability to capture more than 95% of invasive breast tumors.

In late 2007, UF researchers presented findings about the diagnostic value of MRI in influencing treatment plans for women, citing that it can find previously undetected cancerous areas, including cancer in the opposite breast. MRI also helps to better determine tumor size and assess an individual's response to chemotherapy, making it useful for planning surgical procedures, according to UF surgeons.

Related Links:
University of Florida Shands Cancer Center

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57 (!!!!! 1544.9523925781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

58 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

59 (149.01161193848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

60 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

61 (114.91775512695): 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

62 (679.96978759766): SELECT fid FROM jos_deeppockets WHERE id=294724361 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294724361 AND published='1' LIMIT 1

63 (379.08554077148): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (67.949295043945): select jos_twitters.link from jos_twitters where cat=10

65 (36.001205444336): select jos_facebook.link from jos_facebook where cat=10

66 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

68 (47.922134399414): SELECT fid FROM jos_deeppockets WHERE id=294724361 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294724361 AND published='1' LIMIT 1

69 (33.855438232422): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (385.99967956543): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (359.05838012695): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (69.856643676758): 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 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (42.915344238281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (27.894973754883): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (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`

90 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

105 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

106 (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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (53.882598876953): 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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

109 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

110 (88.930130004883): 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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (689.98336791992): 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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (649.92904663086): 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 (442.9817199707): 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 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

115 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

116 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

117 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

118 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

119 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

120 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

121 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

122 (314.95094299316): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 21676.778793335): 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

124 (531.91184997559): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724361 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724361 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7388.1149291992): ( 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 (92.983245849609): ( 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 (285.86387634277): 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

128 (64.849853515625): 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

129 (221.96769714355): 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

130 (75.101852416992): 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

131 (193.83430480957): 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

132 (38.14697265625): 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

133 (181.91337585449): 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

134 (66.995620727539): 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

135 (442.9817199707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (319.00405883789): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (251.05476379395): SELECT name FROM jos_deeppockets WHERE id=212

138 (32.186508178711): SELECT name FROM jos_deeppockets WHERE id=212

139 (614.16625976562): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (450.13427734375): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

142 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

143 (!!!!! 8086.2045288086): TRUNCATE TABLE jos_trademed_module

144 (94.890594482422): 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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (56.982040405273): 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=294724361 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (828.98139953613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

149 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

150 (!!!!! 1543.9987182617): 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

151 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

152 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

153 (32.901763916016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724361 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724361 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (29.087066650391): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (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=212 or channel_id is null)

156 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (139.95170593262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

158 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724361 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724361 AND published='1' LIMIT 1

159 (118.01719665527): select jos_twitters.link from jos_twitters where cat=10

160 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

161 (27.894973754883): select jos_google_plus.link from jos_google_plus where cat=10

162 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

163 (416.04042053223): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (972.98622131348): insert into jos_banners_delta values (14615,'2025-06-29 05:58:34','216.73.216.249','view'),(14202,'2025-06-29 05:58:34','216.73.216.249','view'),(14203,'2025-06-29 05:58:34','216.73.216.249','view')

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