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AI-Aided MRI Provides Cost-Effective Alternative to Painful, Invasive Liver Biopsies

By MedImaging International staff writers
Posted on 29 Sep 2022

Image: LiverMultiScan provides three metrics in one single scan that represent amount of fibro-inflammation, fat, and iron in the liver (Photo courtesy of Perspectum)

Patients with autoimmune hepatitis (AIH), a chronic condition, require lifelong treatment with corticosteroids and immunosuppressants. Their clinical management is challenging, with most patients experiencing recurring periods of subdued, followed by flared disease activity - requiring close and continual monitoring using a liver biopsy to adjust drug dose. The expensive, invasive, and imperfect nature of liver biopsy, together with its poor patient acceptance and associated safety risks, especially in children, are driving the urgent need to replace it with cost-effective noninvasive techniques that can accurately monitor disease activity and treatment response in patients with AIH. Now, a new study has shown that an artificial intelligence-enhanced, noninvasive liver health diagnostic tool can be a cost-effective alternative to painful, invasive liver biopsies for monitoring disease activity and treatment response in patients with AIH.

The health economic study performed by Oxford Academic Health Science Network (AHSN, Oxford, UK) showed that Perspectum’s (Oxford, UK) LiverMultiScan could deliver estimated significant cost savings of up to GBP 336,926 for 100 patients over five years if the AI diagnostic tool replaced surveillance liver biopsies in NHS England’s AIH patient care pathways. Over and above reducing healthcare costs, previously published evidence suggests that including LiverMultiScan in the clinical care of patients with AIH could improve clinical decision-making, patient safety, and experience.

LiverMultiScan is a noninvasive MRI scan to aid in the detection of chronic liver disease, delivering a precision image and a detailed, visual report, with quantitative metrics to assess liver tissue characteristics and provide a comprehensive picture of liver health. In a single 15-minute noninvasive MRI procedure, LiverMultiScan provides three clinically significant metrics measuring fibro-inflammation by iron-corrected T1 (cT1), liver fat, measured by proton density fat fraction (PDFF), and correlates of liver iron levels (T2) to help assess the extent of liver disease. LiverMultiScan is the only technology measuring cT1, a proprietary biomarker that measures the level of fibro-inflammation, offering the potential for earlier diagnosis even at the stage when disease progression can still be stopped and reversed, as well as monitoring of disease progression or regression.

“Noninvasive imaging with LiverMultiScan can detect the presence and extent of liver fibro-inflammation in a risk-free manner, resulting in reduced liver biopsy frequency for AIH patients,” noted Mamta Bajre, MBBS, M.Sc. Health Economics, lead author of the study and member of the NHS England’s Oxford AHSN. “Our study demonstrates that integrating LiverMultiScan in AIH patient pathways leads to significant cost savings for the NHS, while reducing hospitalisation and management costs associated with liver biopsy. By eliminating risks and complications associated with liver biopsy, LiverMultiScan helps improve patient outcomes and experience.”

“Although necessary for diagnosis, liver biopsy is not sustainable for long-term monitoring of patients with AIH. Factoring in LiverMultiScan’s economic benefits shown in this independent study with its ability to positively impact clinical management by detecting sub-clinical disease and predicting clinical outcomes, along with feedback from all stakeholders involved in patient care, I can say LiverMultiScan is probably one of the best monitoring tools to support the management of patients with AIH,” said Elizabeth Shumbayawonda, Ph.D., a clinical scientist spearheading the research in AIH and other autoimmune liver diseases at Perspectum.

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64 (52.928924560547): select jos_twitters.link from jos_twitters where cat=10

65 (26.941299438477): select jos_facebook.link from jos_facebook where cat=10

66 (27.894973754883): select jos_google_plus.link from jos_google_plus where cat=10

67 (27.179718017578): select jos_linkedin.link from jos_linkedin where cat=10

68 (33.140182495117): SELECT fid FROM jos_deeppockets WHERE id=294794755 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294794755 AND published='1' LIMIT 1

69 (28.848648071289): 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 (179.05235290527): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (148.05793762207): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (52.928924560547): 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 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): 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 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): 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 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (44.107437133789): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (28.133392333984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): 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 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1222.8488922119): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

105 (!!!!! 10071.992874146): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

106 (269.88983154297): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (914.09683227539): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 2744.9131011963): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

109 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

110 (!!!!! 3315.9255981445): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 1326.0841369629): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (818.96781921387): 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 (!!!!! 2979.9938201904): 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 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

115 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

116 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

117 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

118 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

119 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

120 (416.04042053223): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 44672.966003418): 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 (!!!!! 3633.0223083496): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

123 (!!!!! 1838.9225006104): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

124 (733.85238647461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794755 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794755 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1322412.9676819): ( 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 (!!!!! 2448.0819702148): ( 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 (453.94897460938): 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 (84.161758422852): 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 (297.06954956055): 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 (48.160552978516): 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 (195.02639770508): 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 (34.093856811523): 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 (486.85073852539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 1351.1180877686): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (727.89192199707): SELECT name FROM jos_deeppockets WHERE id=212

136 (68.902969360352): SELECT name FROM jos_deeppockets WHERE id=212

137 (628.94821166992): 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 (!!!!! 2335.0715637207): 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 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

140 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

141 (!!!!! 16603.946685791): TRUNCATE TABLE jos_trademed_module

142 (916.95785522461): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (654.93583679199): 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=294794755 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (455.14106750488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

147 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

148 (!!!!! 1121.997833252): 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 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

150 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

151 (95.129013061523): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794755 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794755 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (39.100646972656): 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 (28.133392333984): 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 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3470.8976745605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

156 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794755 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794755 AND published='1' LIMIT 1

157 (168.0850982666): select jos_twitters.link from jos_twitters where cat=10

158 (46.014785766602): select jos_facebook.link from jos_facebook where cat=10

159 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

160 (37.908554077148): select jos_linkedin.link from jos_linkedin where cat=10

161 (289.9169921875): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1135.1108551025): insert into jos_banners_delta values (14615,'2025-04-30 15:03:38','3.135.236.62','view'),(14202,'2025-04-30 15:03:38','3.135.236.62','view'),(14203,'2025-04-30 15:03:38','3.135.236.62','view')

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