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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Breast-Specific Gamma Imaging Can Reduce the Number of Unnecessary Breast Biopsies

By MedImaging International staff writers
Posted on 16 Apr 2009

Women who require additional diagnostic imaging after a questionable mammogram may be at risk for unnecessary biopsies when only magnetic resonance imaging (MRI) is offered, according to a new study.

The new findings on breast-specific gamma imaging (BSGI) technology and MRI with regard to breast biopsies were presented at the 19th annual U.S. National Interdisciplinary Breast Center Conference in Las Vegas, NV, USA, in March 2009. "Our goal was to see if BSGI could be used to improve upon the specificity of MRI, and also reduce the number of biopsies. The study is important because with the addition of BSGI, we could eliminate the need for 50% of biopsies or possibly change a patient's decision to have more radical surgery," said Dr. Leora Lanzkowsky, director of women's imaging, Catholic Healthcare West- (CHW)-Nevada Imaging Centers (Las Vegas, NV, USA).

BSGI has comparable sensitivity but superior specificity when compared to MRI. Sensitivity refers to the ability of an imaging technique to detect the presence of disease. Specificity refers to the technique's ability to detect that disease is actually not present.

BSGI, a molecular breast imaging technique, is a follow-up to mammography that can see lesions independent of tissue density and discover early stage cancers. With BSGI, the patient receives a pharmaceutical tracing agent that is absorbed by all the cells in the body. Due to their increased rate of metabolic activity, cancerous cells in the breast absorb a greater amount of the tracing agent than normal, healthy cells and generally appear as "hot spots" on the BSGI image.

Over the course of 18 months, at three medical centers, BSGI and MRI were performed in women requiring additional diagnostic imaging following a mammogram as deemed necessary by a physician. Most of these patients had either a personal history of breast cancer or a combination of other factors placing them at high-risk for breast carcinoma. The interpreting radiologist had access to all prior images and patient information for image interpretation for both studies. All biopsies were performed as deemed necessary by a physician.

In the 4th study, there were 120 women who had 122 abnormal biopsies requiring additional intervention. There were a total of 16 high-risk lesions (11 ADH, four LCIS, and one papilloma) and 106 malignant lesions (17 DCIS, 70 IDC, 14 ILC, three papillary carcinomas, one tubular and one squamous cell carcinoma). BSGI was negative in a total of 10 cases (six malignancies and four high risk lesions) and indeterminate in three (all malignancies). MRI was negative in a total of 11 cases (seven malignancies and four high risk lesions) and indeterminate in six (three malignancies and three high-risk lesions). Excluding the indeterminate findings from the sensitivity analysis, BSGI was positive in 110/120 cases (90.6% sensitivity) and MRI was positive in 106 out of 117 cases (90.6% sensitivity). BSGI was equal in sensitivity to breast MRI in the detection of malignant and high-risk breast lesions, while reducing the rate of indeterminate findings by 50%.

Of the 37 patients who had benign biopsy results, MRI and BSGI were concordant in 16 patients yielding a specificity of 38%. For the patients with discordant MRI and BSGI findings, BSGI specificity was 52% while MRI had a specificity of 19%. Overall, the specificity for BSGI and MRI were 46% and 27%, respectively. "If we can utilize BSGI to avoid unnecessary biopsies, not only are we saving women from an uncomfortable procedure, scarring and the expense of surgery, we save time so patients can move more quickly to treatment," said Dr. Lanzkowsky. "In this group of patients with complex radiographic findings requiring both BSGI and MRI in the course of clinical care, BSGI provided comparable sensitivity, higher specificity, and fewer indeterminate results than MRI."

One such developer of the technology, Dilon Technologies, Inc. (Newport News, VA, USA), has the Dilon 6800, a high-resolution, compact gamma camera optimized to perform BSGI. The camera provides a manageable four to 16 images versus up to thousands of images with breast MRI.

Related Links:
CHW-Nevada Imaging Centers
Dilon Technologies

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59 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

60 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

61 (110.86463928223): 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 (465.86990356445): SELECT fid FROM jos_deeppockets WHERE id=294722838 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722838 AND published='1' LIMIT 1

63 (360.96572875977): 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 (41.961669921875): 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 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE id=294722838 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722838 AND published='1' LIMIT 1

69 (30.994415283203): 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 (370.02563476562): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (258.9225769043): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (50.067901611328): 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 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (44.107437133789): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (31.948089599609): 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 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (58.174133300781): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

105 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

106 (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.cat=10 AND dp.id=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (43.869018554688): 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=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

109 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

110 (53.882598876953): 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=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (496.14906311035): 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=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (559.09156799316): 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 (323.05717468262): 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 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

115 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

116 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

117 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

118 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

119 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

120 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

121 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

122 (272.98927307129): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 20156.145095825): 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 (592.94700622559): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722838 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722838 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (75.101852416992): ( 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 (36.954879760742): ( 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 (35.04753112793): 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 (29.087066650391): 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 (37.908554077148): 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 (35.04753112793): 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 (27.894973754883): 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 (28.133392333984): 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 (28.848648071289): 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 (27.894973754883): 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 (602.96058654785): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (595.8080291748): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (250.10108947754): SELECT name FROM jos_deeppockets WHERE id=213

138 (36.954879760742): SELECT name FROM jos_deeppockets WHERE id=213

139 (812.05368041992): 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 (534.0576171875): 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 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

142 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

143 (!!!!! 8791.9235229492): TRUNCATE TABLE jos_trademed_module

144 (210.04676818848): 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=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (606.06002807617): 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=294722838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (721.93145751953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

149 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

150 (!!!!! 1696.8250274658): 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 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

152 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

153 (33.855438232422): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722838 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722838 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (30.040740966797): 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 (26.941299438477): 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 (41.961669921875): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (692.12913513184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

158 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722838 AND published='1' LIMIT 1

159 (72.956085205078): select jos_twitters.link from jos_twitters where cat=10

160 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

161 (45.061111450195): 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

163 (385.99967956543): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1329.8988342285): insert into jos_banners_delta values (14615,'2025-06-29 11:08:56','216.73.216.249','view'),(14202,'2025-06-29 11:08:56','216.73.216.249','view'),(14203,'2025-06-29 11:08:56','216.73.216.249','view')

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