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AI Outperforms Radiologists in Detecting Prostate Cancer on MRI

By MedImaging International staff writers
Posted on 17 Jun 2024

Image: AI detects prostate cancer more often and reduces false alarms (Photo courtesy of Radboud University)

Radiologists are experiencing an increased workload as more men at high risk of prostate cancer are now routinely undergoing prostate MRI scans. Diagnosing prostate cancer using MRI is complex and requires considerable expertise, which is challenging due to a shortage of experienced radiologists. Now, an international study has demonstrated that artificial intelligence (AI) can alleviate these challenges by identifying prostate cancer more frequently than radiologists and generating fewer false alarms.

In this first large-scale study coordinated by Radboud University Medical Center (Nijmegenm, the Netherlands), an international research team conducted a transparent evaluation comparing AI with radiologist assessments against clinical outcomes. The researchers organized a major competition between AI teams and radiologists, involving participants from various centers in the Netherlands and Norway, who provided over 10,000 MRI scans. Each patient's scans were reviewed to confirm the presence of prostate cancer, allowing groups worldwide to develop AI tools for image analysis. The top five AI submissions were integrated into a super-algorithm for assessing prostate MRI scans. These AI assessments were then compared with those made by a panel of radiologists on four hundred scans. The PI-CAI community study engaged over two hundred AI teams and 62 radiologists from 20 countries in this initiative. They compared AI findings not only with those of radiologists but also against a gold standard, tracking the outcomes of the men whose scans were analyzed over an average follow-up of five years.

This pioneering international PI-CAI study on AI in prostate diagnostics revealed that AI detected nearly 7% more significant prostate cancers than the radiologists did. Furthermore, AI identified half as many non-cancerous suspicious areas compared to radiologists, suggesting that the number of unnecessary biopsies could potentially be reduced by half with AI integration. If these findings are consistent in further studies, they could significantly aid radiologists and patients by reducing radiologists’ workload, improving diagnostic accuracy, and decreasing unnecessary prostate biopsies. The AI developed through this study still requires validation and is not yet available for clinical use. The project leaders note that societal trust in AI is limited, as some systems developed are subpar. They are now focused on creating a public and transparent testing platform to fairly evaluate AI systems and are developing a quality management system similar to that used in the aviation industry.

“If planes almost collide, a safety committee will look at how to improve the system so that it doesn't happen in the future,” said Henkjan Huisman, AI expert and project leader of the PI-CAI study. “I want the same for AI. I want to research and develop a system that learns from every mistake so that AI is monitored and can continue to improve. That way, we can build trust in AI for healthcare. Optimal, governed AI can help make healthcare better and more efficient.” The findings of the PI-CAI study were published in The Lancet Oncology on June 11, 2024.

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61 (142.09747314453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

62 (!!!!! 1188.0397796631): 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

63 (!!!!! 1024.9614715576): SELECT fid FROM jos_deeppockets WHERE id=294801560 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294801560 AND published='1' LIMIT 1

64 (88.930130004883): 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`

65 (77.962875366211): select jos_twitters.link from jos_twitters where cat=10

66 (41.961669921875): select jos_facebook.link from jos_facebook where cat=10

67 (962.0189666748): select jos_google_plus.link from jos_google_plus where cat=10

68 (94.890594482422): select jos_linkedin.link from jos_linkedin where cat=10

69 (!!!!! 2076.1489868164): SELECT fid FROM jos_deeppockets WHERE id=294801560 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294801560 AND published='1' LIMIT 1

70 (146.15058898926): 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`

71 (!!!!! 7610.0826263428): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 10251.045227051): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (659.22737121582): 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`

74 (621.08039855957): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (134.22966003418): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (186.20491027832): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (478.02925109863): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (747.2038269043): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (484.94338989258): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (80.108642578125): 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`

91 (99.18212890625): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 2856.969833374): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (102.99682617188): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

106 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

107 (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 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (70.095062255859): 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (!!!!! 2635.9558105469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

110 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

111 (267.98248291016): 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (900.0301361084): 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (761.98577880859): 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 (545.97854614258): 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

115 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

116 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

117 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

118 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

119 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

120 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

121 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

122 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

123 (588.89389038086): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

124 (!!!!! 58110.952377319): 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

125 (!!!!! 1135.1108551025): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294801560 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294801560 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (303.98368835449): ( 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 (55.074691772461): ( 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

128 (233.17337036133): 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 (468.96934509277): 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

130 (618.93463134766): 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 (128.03077697754): 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

132 (174.04556274414): 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 (46.014785766602): 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

134 (339.03121948242): 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 (345.94535827637): 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

136 (530.00450134277): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (426.05400085449): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (58.174133300781): SELECT name FROM jos_deeppockets WHERE id=212

139 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=212

140 (823.02093505859): 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 (674.96299743652): 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

142 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

143 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

144 (!!!!! 17259.120941162): TRUNCATE TABLE jos_trademed_module

145 (!!!!! 2490.9973144531): 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (117.06352233887): 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=294801560 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (552.17742919922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

150 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

151 (!!!!! 4981.9946289062): 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

152 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

153 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

154 (56.028366088867): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294801560 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294801560 AND type='deeppockets_item' AND published='1' LIMIT 1

155 (43.153762817383): 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 (38.862228393555): 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)

157 (53.882598876953): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

158 (91.791152954102): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

159 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294801560 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294801560 AND published='1' LIMIT 1

160 (296.11587524414): select jos_twitters.link from jos_twitters where cat=10

161 (47.922134399414): select jos_facebook.link from jos_facebook where cat=10

162 (41.007995605469): select jos_google_plus.link from jos_google_plus where cat=10

163 (!!!!! 3916.0251617432): select jos_linkedin.link from jos_linkedin where cat=10

164 (400.78163146973): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

165 (!!!!! 1331.090927124): insert into jos_banners_delta values (14615,'2025-08-02 02:59:12','216.73.216.210','view'),(14202,'2025-08-02 02:59:12','216.73.216.210','view'),(14203,'2025-08-02 02:59:12','216.73.216.210','view')

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