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Novel Brain MRI Technique Helps Identify Multiple Sclerosis Lesions

By MedImaging International staff writers
Posted on 25 Apr 2022

Image: Images show novel brain MRI techniques for detecting Central Vein Sign (Photo courtesy of Cedars-Sinai)

In patients with multiple sclerosis (MS), the immune system attacks the insulating layer that protects nerves. The disruption or loss of these layers results in lesions, which show up as white spots on MRI brain scans—the main tool for diagnosing the condition. But MS is not the only condition that can cause white spots to appear on an MRI and migraines are the most common cause of non-MS white spots on MRIs. As a result, patients who are misdiagnosed with MS are needlessly prescribed costly immune-modifying treatments that can increase risk for infection, cause organ damage and decrease the effectiveness of vaccines. Now, researchers are using advanced techniques for imaging the brain and eyes, along with new biomarkers, to present a clearer picture of MS. Their work could lead to improved diagnosis and treatment of the disease.

A team of physician and scientists in the Department of Neurology at Cedars-Sinai (Los Angeles, CA, USA) has identified biological sign called “central vein sign” that could help physicians determine whether white spots on a patient’s MRI are caused by MS or by something else, ultimately reducing misdiagnosis. MS lesions tend to form around tiny veins through which immune cells enter and attack brain tissue, so most lesions caused by MS have a vein in the middle. New MRI techniques pioneered by the researchers make central vein sign visible.

Ongoing studies at Cedars-Sinai and 10 other MS centers in North America are using the new technique to image 400 patients at risk of developing MS - the final step in scientifically validating central vein sign as a way to diagnose MS. Importantly, the new imaging technique can be used with widely available MRI scanners and performed quickly enough to fit the workflow of the typical radiology center. The team is also developing a machine learning algorithm to make evaluation of the imaging results easier for physicians. The central vein sign could also help doctors determine how well a patient is responding to treatment by confirming that any new lesions that develop are caused by MS and not something else.

The researchers are also focusing on imaging of the retina - the layer of tissue at the back of the eye - and the optic nerve that can also help improve MS diagnosis. Using a technology called optical coherence tomography (OCT), which functions like an MRI for the retina and optic nerve, the team has shown it can detect MS lesions that an MRI can miss. Optical coherence tomography captures 3D images of patients’ retinal layers, including the ganglion cell layer, which sends visual information to the brain. Retinal imaging could also help indicate how well a patient is responding to treatment. The team is continuing to study the role of OCT, along with a related technique called optical coherence tomography angiography (OCTA), as a way to understand how MS affects the blood vessels in the retina. While ocular nerve and retinal imaging is important to evaluate in MS patients, it is not yet widely available in practice. The team hopes their research will help change the standard of diagnostic care.

“Current MRI images don’t give us the whole picture, which is why we developed MRI sequences that improve image quality so that we can see very small veins, called veinules, in the brain,” said Pascal Sati, PhD, director of the Neuroimaging Program in the Department of Neurology and associate professor of Neurology at Cedars-Sinai, who pioneered the MRI technique. “We superimpose that over a conventional MRI image of the lesions so that it is clear which brain lesions have a central vein and are likely caused by MS.”

“Once the image is taken, our deep learning algorithm can analyze it very quickly and tell the clinician how many lesions show the central vein sign,” added Sati. “The number of lesions with the central vein sign can indicate whether or not the patient has MS.”

“The optic nerves are very small and difficult to image. Detecting lesions there can help us clinch an MS diagnosis, especially in patients who are relatively early on in their disease course,” said neurologist Omar Al-Louzi, MD, director of the Visual Outcomes Laboratory at Cedars-Sinai, whose research seeks to use the eye as a window to produce better outcomes for patients. “Shrinking of the ganglion cell layer often mirrors overall brain degeneration, and occurs in 70% to 80% of MS patients. This is why ganglion imaging could also help us improve diagnosis.”

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61 (76.055526733398): 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 (999.92752075195): SELECT fid FROM jos_deeppockets WHERE id=294792620 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294792620 AND published='1' LIMIT 1

63 (64.849853515625): 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 (!!!!! 4726.1714935303): select jos_twitters.link from jos_twitters where cat=10

65 (71.048736572266): select jos_facebook.link from jos_facebook where cat=10

66 (50.067901611328): select jos_google_plus.link from jos_google_plus where cat=10

67 (46.968460083008): select jos_linkedin.link from jos_linkedin where cat=10

68 (616.78886413574): SELECT fid FROM jos_deeppockets WHERE id=294792620 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294792620 AND published='1' LIMIT 1

69 (63.896179199219): 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 (633.00132751465): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (731.9450378418): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (59.843063354492): 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 (89.883804321289): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 2638.1015777588): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (91.075897216797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (195.02639770508): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 1535.8924865723): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (71.048736572266): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (77.009201049805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (44.822692871094): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (46.968460083008): 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 (79.870223999023): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 4322.0520019531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

105 (132.08389282227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

106 (159.02519226074): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (676.87034606934): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

109 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

110 (83.208084106445): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (723.12355041504): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (816.82205200195): 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 (!!!!! 3408.9088439941): 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 (573.87351989746): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

115 (413.89465332031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

116 (955.10482788086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

117 (310.89782714844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

118 (!!!!! 5882.9784393311): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

119 (!!!!! 5332.9467773438): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

120 (!!!!! 4317.9988861084): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 119565.96374512): 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 (!!!!! 1076.9367218018): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

123 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

124 (992.0597076416): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792620 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792620 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1776953.9356232): ( 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 (!!!!! 1492859.8403931): ( 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 (172.13821411133): 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 (116.82510375977): 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 (133.03756713867): 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 (109.91096496582): 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 (74.148178100586): 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 (57.93571472168): 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 (394.10591125488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (386.95335388184): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (94.890594482422): SELECT name FROM jos_deeppockets WHERE id=212

136 (29.087066650391): SELECT name FROM jos_deeppockets WHERE id=212

137 (555.99212646484): 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

138 (442.9817199707): 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

139 (!!!!! 1573.0857849121): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

140 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

141 (!!!!! 20720.958709717): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1507.9975128174): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (632.04765319824): 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=294792620 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (384.09233093262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (894.06967163086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 2547.9793548584): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

147 (411.03363037109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

148 (!!!!! 1629.114151001): 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 (!!!!! 1474.8573303223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

150 (230.07392883301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

151 (!!!!! 1450.0617980957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792620 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792620 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (!!!!! 1229.0477752686): 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)

153 (!!!!! 1182.0793151855): 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)

154 (!!!!! 1224.0409851074): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 2319.0975189209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

156 (!!!!! 4178.0471801758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792620 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792620 AND published='1' LIMIT 1

157 (64.849853515625): select jos_twitters.link from jos_twitters where cat=10

158 (40.054321289062): select jos_facebook.link from jos_facebook where cat=10

159 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

160 (46.014785766602): select jos_linkedin.link from jos_linkedin where cat=10

161 (346.89903259277): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2418.041229248): insert into jos_banners_delta values (14615,'2025-06-17 12:29:29','216.73.216.120','view'),(14202,'2025-06-17 12:29:29','216.73.216.120','view'),(14203,'2025-06-17 12:29:29','216.73.216.120','view')

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