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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Technology Fuses MRI, Ultrasound for Targeted Biopsy of Prostate Cancer

By MedImaging International staff writers
Posted on 07 Jun 2011

Targeted biopsy, an important development in prostate cancer diagnostics, fuses magnetic resonance imaging (MRI) with real-time three-dimensional (3D) ultrasound, providing a precise method to obtain biopsy specimens from suspicious areas in the prostate.

The unique fusion method provides a major improvement in the way prostate biopsy is performed since the current biopsy methods were developed in the mid-1980s, according to the University of California, Los Angeles (UCLA; USA) Professor of urology Dr. Leonard S. Marks, a study author.

Four UCLA departments--urology, radiology, pathology, and biomedical engineering--collaborated with the medical device company Eigen, Inc. (Grass Valley, CA, USA) to develop and evaluate the technology. The team's preliminary experiences are reported in the online May/June 2011 issue of the journal Urologic Oncology.

"It's difficult to identify and target suspicious areas using two-dimensional, conventional ultrasound, so urologists currently take samples systematically from the entire prostate," said Dr. Marks. "The advent of MRI-ultrasound fusion has led to a promising advance in prostate imaging and biopsy targeting. Despite the technology revolution of the past several decades, we are still performing prostate biopsies just the same as in the mid-1980s. We are hopeful that new imaging methods like MRI-ultrasound fusion may soon change that."

Dr. Marks noted that the new technology might be most beneficial for patients who fall into one of two categories: those who had prior negative biopsies, but have persistently elevated prostate-specific antigen (PSA) levels, and "active surveillance" patients--those with low-risk prostate cancers who are being carefully monitored over time to see if their cancer progresses or becomes more aggressive.

The study, conducted between 2009 and 2010, involved 218 men between the ages of 35 and 87, all of whom received prostate biopsies. Of the 218, 47 men who fell into one of the two categories mentioned above received prostate biopsies using MRI images fused with real-time ultrasound. These patients first received MRI scans of the prostate that assessed three components in detecting cancer: suspicious contrasts in tissue, abnormal cellular density, and unusual blood flow within the prostate.

"While other major cancers can be imaged within the organ of origin, the small, compact prostate has proven elusive for a number of reasons, such as the similarity of cancer and benign tissue and the lack of tissue uniformity," said study author Dr. Daniel Margolis, an assistant professor of radiology in abdominal imaging and codirector of prostate imaging at the David Geffen School of Medicine at UCLA. "We hope the multiparameter MRI information, used with the new system, will help us better distinguish problem areas and provide the most accurate information possible."

After reviewing the MRI prostate scans, Dr. Margolis individually graded each component and provided an overall score to gauge cancer risk. He noted that the additional MRI information might help improve targeting and possibly eliminate the need for taking multiple biopsy samples. Currently, 12 areas from the entire prostate are systematically biopsied, whether they are suspicious areas or not.

For the next phase, UCLA biomedical engineer Dr. Shyam Natarajan took the data and scores from the MRI prostate scans and, using software created at UCLA, generated a 3D image of the 47 patients' prostates, which clearly showed the location of any suspicious areas. The information was transferred to a CD that was ready for use in the clinic during a real-time ultrasound prostate biopsy.

During the prostate biopsy, the CD was loaded into Artemis, a 3D prostate biopsy system that allows the stored MRI images to be electronically transferred and fused with the real-time ultrasound, providing a 3D image similar to a roadmap to help guide the tiny biopsy needle into targeted areas.

"The application of such three-dimensional imaging or modeling is used in other fields, like animation and gaming, and is also being used more frequently in developing medical diagnostics," said Dr. Natarajan, an author of the study and a researcher at both the UCLA Henry Samueli School of Engineering and Applied Science and the UCLA Center for Advanced Surgical and Interventional Technology.

The other 171 men in the study did not undergo MRI but received prostate biopsies in which the Artemis tracking system was attached to the ultrasound probe, allowing their prostates to be scanned using 3D imaging, which may be beneficial in providing more even distribution of the biopsy sites when using conventional ultrasound technology, according to the study authors.

The UCLA team found that targeted biopsy was about five times more likely to find cancer than nontargeted, systematic biopsy. Re-biopsy of a suspicious site was found to be accurate within a few millimeters. The team is also helping track the accuracy of MRI-ultrasound fusion by studying cancerous prostates that have been removed from study patients. The researchers can then compare the location of the diseased tissue on the actual prostate with the MRI and ultrasound fusion scans.

"Using the actual prostate tissue allows us to pinpoint the exact location of the cancer, as well as assess the cancer's nature, such as determining if it will spread," said study author Dr. Jiaoti Huang, a professor and director of urologic pathology in the department of pathology at the Geffen School of Medicine. "We can also gauge the accuracy of the MRI and ultrasound fusion scans in identifying cancer."

Eigen manufacturers the Artemis device. The device was approved by the US Food and Drug Administration in May 2008, but widespread distribution of it has been postponed until further usability development, similar to that underway at UCLA, has been achieved.

Related Links:
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55 (58.889389038086): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

56 (430.82237243652): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1223.087310791): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

58 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

59 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

60 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

61 (77.009201049805): 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 (473.0224609375): SELECT fid FROM jos_deeppockets WHERE id=294735453 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735453 AND published='1' LIMIT 1

63 (272.98927307129): 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 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

65 (29.087066650391): 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 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

68 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE id=294735453 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735453 AND published='1' LIMIT 1

69 (34.093856811523): 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 (247.00164794922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (215.05355834961): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.193298339844): 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 (89.168548583984): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.901763916016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (70.810317993164): 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 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

106 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.968460083008): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

109 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

110 (48.160552978516): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (457.0484161377): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (541.92543029785): 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 (323.05717468262): 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 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

116 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

117 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

118 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

119 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

120 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

122 (274.8966217041): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 19934.177398682): 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 (560.99891662598): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735453 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735453 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7864.9520874023): ( 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 (117.06352233887): ( 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 (344.99168395996): 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 (104.90417480469): 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 (237.94174194336): 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 (36.001205444336): 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 (244.140625): 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 (72.956085205078): 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 (188.82751464844): 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 (64.13459777832): 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 (558.13789367676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (366.9261932373): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (290.87066650391): SELECT name FROM jos_deeppockets WHERE id=212

138 (50.067901611328): SELECT name FROM jos_deeppockets WHERE id=212

139 (607.96737670898): 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 (597.00012207031): 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 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

142 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

143 (!!!!! 16604.900360107): TRUNCATE TABLE jos_trademed_module

144 (89.883804321289): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (82.015991210938): 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=294735453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1516.1037445068): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 4784.107208252): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

149 (362.15782165527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

150 (!!!!! 2470.9701538086): 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 (!!!!! 1008.0337524414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

152 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

153 (77.962875366211): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735453 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735453 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (51.975250244141): 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 (58.889389038086): 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 (67.949295043945): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 1840.8298492432): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

158 (141.85905456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735453 AND published='1' LIMIT 1

159 (92.983245849609): select jos_twitters.link from jos_twitters where cat=10

160 (48.160552978516): select jos_facebook.link from jos_facebook where cat=10

161 (45.061111450195): select jos_google_plus.link from jos_google_plus where cat=10

162 (45.061111450195): select jos_linkedin.link from jos_linkedin where cat=10

163 (402.92739868164): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1462.9364013672): insert into jos_banners_delta values (14615,'2025-06-27 05:33:48','216.73.216.249','view'),(14202,'2025-06-27 05:33:48','216.73.216.249','view'),(14203,'2025-06-27 05:33:48','216.73.216.249','view')

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