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MRI More Accurate at Detecting Prostate Cancer than PSMA PET/CT Scanning

By MedImaging International staff writers
Posted on 05 Jul 2022

Image: New imaging technology is less accurate than MRI at detecting prostate cancer (Photo courtesy of Pexels)

Prostate-specific membrane antigen (PSMA) PET/CT scans are presently used to manage prostate cancer, as they can accurately measure the progression or recurrence of the disease. Approved by the US FDA in 2020, they use a radioactive dye to ‘light up’ areas of PSMA, which is found on the surface of prostate cancer cells. Now, a study has found that MRI scans can detect prostate cancer more accurately than the newer, prostate-specific -PSMA PET/CT scanning technique.

A team of researchers at St. Vincent’s Hospital (Melbourne, Australia) conducted a clinical trial to find if prostate-specific -PSMA PET/CT scans could be used to diagnose prostate cancer as well. The PEDAL trial recruited 240 patients across five hospital groups who were at risk of prostate cancer. Every patient was given both an MRI scan and a PSMA PET/CT scan. If imaging suggested the presence of prostate cancer, a biopsy was performed by the patient’s urologist.

The MRI scans picked up abnormalities in 141 patients, while the PSMA PET/CT scans picked up abnormalities in 198 patients. A total of 181 patients (75%) underwent a prostate biopsy, and subsequently 82 of those patients were found to have clinically significant prostate cancer. Since each patient had both type of scans, the researchers could assess which type had more accurately detected those patients who had prostate cancer. The researchers found that MRI scans were significantly more accurate at detecting any grade of prostate cancer than the PSMA PET scans (0.75% for MRI vs. 0.62% for PSMA PET). Although detection thresholds will be fine-tuned as diagnostic use develops, the researchers believe the trial has important lessons for clinicians.

“Our analysis found that MRI scans were better than PSMA-PET for detecting any grade of prostate cancer. When we looked only at clinically significant prostate cancers, there was no difference in accuracy. As this study is one of the first to explore using PSMA-PET to diagnose cancer within the prostate, we are still learning and adjusting how to improve using PSMA-PET in this setting,” said Associate Professor Lih-Ming Wong, Consultant Uro-oncologist at St Vincent’s Hospital, who headed the research team. “This study confirms that the existing ‘gold standard’ of pre-biopsy detection – the MRI – is indeed a high benchmark. Even with fine-tuning, we suspect PSMA PET/CT won’t replace the MRI as the main method of prostate cancer detection. But it will likely have application in the future as an adjunct to the MRI, or for people for whom an MRI is unsuitable, or as a single combined "diagnostic and staging” scan for appropriately selected patients.”

“New diagnostic tools need to be tested as carefully as new drugs, so we welcome the findings of this remarkable Phase III trial, which showed that MRI was superior in the detection of any prostate cancer,” added Professor Peter Albers, Chair of the European Association of Urology’s Chief Scientific Office. “It also showed that PSMA PET/CT was not inferior to MRI in the detection of clinically significant cancers (ISUP 2 and higher); and since the ultimate goal of primary staging will be to detect only the more aggressive cancers and avoid unnecessary biopsy, this is not the end of the story. More research will be needed to explore the PSMA PET/CT correlation between the standard uptake value (SUV) and cancer aggressiveness, but the first steps down the road in finding the best diagnostic approach to clinically significant prostate cancer have been taken.”

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63 (957.96585083008): 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 (50.067901611328): select jos_twitters.link from jos_twitters where cat=10

65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

66 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

68 (34.093856811523): SELECT fid FROM jos_deeppockets WHERE id=294793724 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793724 AND published='1' LIMIT 1

69 (31.948089599609): 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 (!!!!! 1132.0114135742): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (288.96331787109): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (40.054321289062): 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 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (39.100646972656): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (27.179718017578): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (32.901763916016): 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 (314.95094299316): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (280.14183044434): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (136.13700866699): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (251.05476379395): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (494.95697021484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

105 (283.00285339355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

106 (55.074691772461): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (410.79521179199): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (679.96978759766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

109 (124.21607971191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

110 (51.021575927734): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (477.07557678223): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (587.94021606445): 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 (381.9465637207): 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 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

115 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

116 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

117 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

118 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

120 (290.1554107666): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 39122.104644775): 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 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

123 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

124 (461.81678771973): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793724 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793724 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 566204.07104492): ( 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 (104.90417480469): ( 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 (444.88906860352): 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 (55.074691772461): 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 (367.16461181641): 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 (78.916549682617): 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 (249.86267089844): 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 (41.961669921875): 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 (617.98095703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 2115.9648895264): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (916.0041809082): SELECT name FROM jos_deeppockets WHERE id=212

136 (720.97778320312): SELECT name FROM jos_deeppockets WHERE id=212

137 (847.10121154785): 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 (!!!!! 1177.7877807617): 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 (!!!!! 4925.012588501): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

140 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

141 (!!!!! 7488.0123138428): TRUNCATE TABLE jos_trademed_module

142 (232.93495178223): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (87.02278137207): 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=294793724 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (684.97657775879): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (242.94853210449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

147 (171.89979553223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

148 (!!!!! 1417.875289917): 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 (146.86584472656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

150 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

151 (827.07405090332): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793724 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793724 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (45.7763671875): 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 (35.04753112793): 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 (41.007995605469): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3813.0283355713): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

156 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793724 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793724 AND published='1' LIMIT 1

157 (564.0983581543): select jos_twitters.link from jos_twitters where cat=10

158 (!!!!! 1705.1696777344): select jos_facebook.link from jos_facebook where cat=10

159 (523.09036254883): select jos_google_plus.link from jos_google_plus where cat=10

160 (401.02005004883): select jos_linkedin.link from jos_linkedin where cat=10

161 (!!!!! 1248.1212615967): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2955.9135437012): insert into jos_banners_delta values (14615,'2025-04-30 21:15:10','3.145.80.205','view'),(14202,'2025-04-30 21:15:10','3.145.80.205','view'),(14203,'2025-04-30 21:15:10','3.145.80.205','view')

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