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PET/CT is Superior to 3T MRI for Whole-Body Primary Tumor Staging

By MedImaging staff writers
Posted on 21 Apr 2008

Determining how far a patient's cancer has metastasized is crucial in planning and optimizing treatment. A variety of imaging techniques now provide essential tools for staging primary tumors, including positron emission tomography (PET), compute tomography (CT), and magnetic resonance imaging (MRI), but a new comparative study revealed that fused whole-body PET/CT to be considerably more accurate than whole-body MRI--even at 3 Tesla--for primary tumor staging.

Between November 2002 and January 2008, a group of Italian investigators evaluated the effectiveness of whole-body FDG-PET/CT images versus images from CT alone, CT+PET images viewed side-by-side, and whole-body 3-Tesla MR images. They presented the findings of their study in March 2008 at the 2008 European Congress of Radiology (ECR), held in Vienna, Austria. "The aim of the study was to determine the potential benefits concerning patient management when staging primary tumors--that is, the diagnostic advantages and impact on treatment,” said Dr. Stefano Mancino, from Tor Vergata University (Rome, Italy).

The patients in the study had a range of cancers, including five cases of breast cancer, four lung cancers, three liver carcinomas, two melanomas, and six lymphomas. The researchers obtained CT and PET/CT images of the patients using a PET/CT scanner (Discovery ST PET/CT system, developed by GE Healthcare; Chalfont St. Giles, UK) with an acquisition time of approximately 30 minutes, while the MRI images were acquired on a 3-Tesla machine (Achieva 3.0T MRI system, developed by Philips Healthcare; Best, The Netherlands) using a body coil and an unlimited field-of-view.

Results showed a superior diagnostic performance from fused PET/CT imaging, which was significantly more accurate in assessing overall tumor, node, metastases (TNM) staging versus standalone CT (p < 0.05), side-by-side CT+PET (p < 0.05), and whole-body MRI.

Of the 20 patients in the study, PET/CT accurately staged 16 (80%), side-by-side CT+PET was accurate in 14 (70%) cases, and CT imaging alone identified 13 (65%) cancers, while 3-Tesla MRI correctly staged tumors in 12 (60%) patients. The distinct diagnostic advantages as highlighted in this study were translated into changes and improvements in the clinical management of several patients, according to Dr. Mancino.

There was discordance between PET/CT and MRI results when identifying small lesions in the left liver segment and depicting metastases. PET/CT and side-by-side CT+PET were more sensitive in depicting small bone lesions and pulmonary lesions than CT alone, Dr. Mancino noted.

In specifically assessing metastases (M staging), any differences in the relative performance of PET/CT and CT+PET viewed side by side were not statistically significant, according to Dr. Mancino. He, however, recognized whole-body MRI to be an effective tool for staging cancer patients but added that based on his team's experience, "it cannot reach the accuracy of fused FDG-PET/CT images. Whole-body fused PET/CT is significantly more accurate than CT alone and CT+PET side by side in staging malignant disease,” he concluded.

In related research, Dr. Till Heusner, from the University of Duisburg-Essen (Germany), compared whole-body MRI and whole-body FDG-PET/CT in detecting bone metastases at initial diagnosis in patients with malignant melanoma and nonsmall cell lung cancer (NSCLC). Both imaging procedures were performed within a 14-day period, with a mean interval of 0.6 days. Differences between the imaging procedures were tested for significance using McNemar's test (p < 0.05).

Based on the standard reference that three patients with malignant melanoma and eight with NSCLC had bone metastases (of the total 109-patient study group), the study's revealed that FDG-PET/CT correctly detected bone metastases in five patients, whereas MRI did the same in seven patients.

Each of the five metastases discovered using PET/CT imaging were in the NSCLC group; MRI also found five in this group, and two in the melanoma group. However, both imaging modalities had false-positive results: MRI produced six false positives, whereas PET/CT produced one false-positive result.

While he reported that the results from this relatively small study would benefit from validation in a larger study, Dr. Heusner concluded that whole-body FDG-PET/CT and whole-body MRI were similarly accurate in assessing patients at initial diagnosis of malignant melanoma and NSCLC.

Related Links:
Tor Vergata University
GE Healthcare
Philips Healthcare

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58 (757.93266296387): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

59 (!!!!! 5344.8677062988): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

60 (851.15432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

61 (!!!!! 3153.8009643555): 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 (!!!!! 2640.0089263916): SELECT fid FROM jos_deeppockets WHERE id=278790000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=278790000 AND published='1' LIMIT 1

63 (538.11073303223): 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=213 ORDER BY `ordering`

64 (!!!!! 3880.0239562988): select jos_twitters.link from jos_twitters where cat=10

65 (598.90747070312): select jos_facebook.link from jos_facebook where cat=10

66 (896.93069458008): select jos_google_plus.link from jos_google_plus where cat=10

67 (41.007995605469): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 1378.059387207): SELECT fid FROM jos_deeppockets WHERE id=278790000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=278790000 AND published='1' LIMIT 1

69 (50.067901611328): 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=213 ORDER BY `ordering`

70 (!!!!! 2901.0772705078): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 1940.0119781494): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (82.969665527344): 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 (!!!!! 1386.1656188965): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (85.830688476562): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (190.97328186035): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (860.92948913574): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (48.160552978516): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (122.0703125): 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 (!!!!! 4564.0468597412): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (138.0443572998): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (!!!!! 3651.8573760986): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (126.12342834473): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (139.95170593262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

105 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

106 (87.976455688477): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (75.101852416992): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (149.96528625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

109 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

110 (157.11784362793): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (813.00735473633): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1060.0090026855): 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 (605.10635375977): 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 (668.04885864258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

115 (181.91337585449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

116 (842.09442138672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

117 (!!!!! 1290.7981872559): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

118 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

119 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

120 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

121 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

122 (!!!!! 6926.0597229004): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 57312.01171875): 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 (!!!!! 1019.9546813965): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278790000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278790000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (61.03515625): ( 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 (128.03077697754): ( 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 (329.01763916016): 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 (48.160552978516): 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 (174.04556274414): 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 (66.995620727539): 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 (396.9669342041): 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 (41.007995605469): 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 (195.02639770508): 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 (51.975250244141): 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 (533.10394287109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (386.95335388184): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=213

138 (30.040740966797): SELECT name FROM jos_deeppockets WHERE id=213

139 (661.13471984863): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (607.01370239258): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

142 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

143 (!!!!! 9265.1844024658): TRUNCATE TABLE jos_trademed_module

144 (105.14259338379): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (74.863433837891): 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=278790000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1101.016998291): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

149 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

150 (!!!!! 1600.0270843506): 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 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

152 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

153 (41.007995605469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=278790000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=278790000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (36.001205444336): 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=213 or channel_id is null)

155 (33.140182495117): 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=213 or channel_id is null)

156 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

158 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=278790000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=278790000 AND published='1' LIMIT 1

159 (74.863433837891): select jos_twitters.link from jos_twitters where cat=10

160 (51.021575927734): select jos_facebook.link from jos_facebook where cat=10

161 (47.206878662109): select jos_google_plus.link from jos_google_plus where cat=10

162 (42.915344238281): select jos_linkedin.link from jos_linkedin where cat=10

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