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Molecular Imaging Predicts Treatment Effectiveness in Many Cancers

By MedImaging International staff writers
Posted on 29 Sep 2010

A series of studies revealed that molecular imaging plays a vital role in the evaluation and treatment planning for a wide range of cancers, including thyroid cancer and lymphoma.

According to researchers, molecular imaging allows physicians to identify the severity and extent of disease and, in turn, provide patients with personalized care. Moreover, molecular imaging allows doctors to see how effective a treatment is early in the process so that changes can be made to ensure the best treatment for each individual patient.

The studies were published in the September 2010 Journal of Nuclear Medicine (JNM). "For patients with thyroid cancer, ‘one size fits all' no longer applies,” said Ravinder Grewal, M.D., corresponding author of one of the published articles and an assistant attending physician in nuclear medicine at Memorial Sloan-Kettering Cancer Center (New York, NY, USA). "Through molecular imaging, the paradigm is changing toward more tailored and customized management of treatment. As a result, we can see how far a disease has spread and spare the patient from additional examination, time, and radiation exposure.”

For the study, researchers performed planar imaging and single-photon emission computed tomography/computed tomography (SPECT/CT) on 148 patients with thyroid cancer. The findings revealed that SPECT/CT provided data that reduced the need for additional cross-sectional imaging in 29 patients and redefined the initial risk of recurrence estimates in seven of 109 patients, thereby changing patient management recommendations in terms of frequency and intensity of follow-up studies.

In another study, researchers in Germany utilized positron emission tomography (PET)/CT with the radiotracer ⁶⁸Ga-DOTATATE to evaluate the effectiveness of molecular imaging in monitoring patients with neuroendocrine tumors after undergoing peptide-receptor radionuclide treatment. This study evaluated 33 patients at baseline and three months after treatment began. The findings suggest that PET/CT may contribute to the early prediction of treatment outcome in patients with neuroendocrine tumors.

"This molecular imaging technique can help doctors to classify patients according to their prognosis and to choose a personalized follow-up strategy,” said Alexander Haug, M.D., corresponding author of the study and a researcher at Ludwig-Maximilians-University (Munich, Germany). "With the use of specific biomarkers, nuclear medicine provides the unique opportunity to perform diagnosis and therapy with the same tracer compound and--with the use of different biomarkers--to provide personalized tissue characterization. Nuclear medicine will be essential for the work-up of cancer patients in the near future."

The third study also used molecular imaging to monitor treatment success and aid in planning. Researchers evaluated 104 patients with newly diagnosed Hodgkin lymphoma using fluorodeoxyglucose (FDG) PET after undergoing two cycles of chemotherapy treatment. Of these patients, 93 achieved complete remission after first-line therapy. During a median follow-up of 36 months, relapse or disease progression was seen in 22 patients. Researchers found that PET is an accurate and independent predictor of event-free survival in Hodgkin lymphoma patients.

"Our findings suggest that early interim FDG-PET may play a pivotal role in Hodgkin lymphoma treatment, tailoring the therapy to an individual level, providing a less toxic treatment for patients with a low risk of failure while attempting treatment intensification for patients regarded as high risk of failure on the basis of the PET findings,” said Juliano Cerci, M.D., division of nuclear medicine, Heart Institute (InCor), Medical School of the University of São Paulo (Brazil), and corresponding author of the last study.

The fourth study investigated the role of ¹⁸F-FDG PET/CT for the early identification of response to therapy in patients with non-small-cell lung cancer (NSCLC). Researchers studied 23 NSCLC patients who were treated with a molecular-targeted agent called epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) and used ¹⁸F-FDG PET/CT to monitor the disease before and at one week after administration of EGFR-TKI. Alterations in tumor ¹⁸F-FDG uptake during treatment were measured by standardized uptake values. Six patients experienced partial response, while 16 patients had stable disease and one patient had progressive disease. The results of the study suggest that early during the course of therapy, ¹⁸F-FDG PET/CT can predict response to treatment in patients with NSCLC.

According to the researchers, monitoring a patient's response to treatment can avoid unnecessary toxicity, as well as the cost of ineffective treatment. They also state that the results of the study are promising and consistent with the results of preclinical studies.

Related Links:
Memorial Sloan-Kettering Cancer Center
Ludwig-Maximilians-University
Medical School of the University of São Paulo

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56 (921.96464538574): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 7435.0833892822): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

58 (!!!!! 8022.0699310303): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

59 (!!!!! 4660.1295471191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

60 (466.10832214355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

61 (!!!!! 7594.8238372803): 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 (!!!!! 5202.054977417): SELECT fid FROM jos_deeppockets WHERE id=294731360 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294731360 AND published='1' LIMIT 1

63 (!!!!! 2995.9678649902): 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 (!!!!! 3212.9287719727): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 7944.1070556641): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 4642.9634094238): select jos_google_plus.link from jos_google_plus where cat=10

67 (284.19494628906): select jos_linkedin.link from jos_linkedin where cat=10

68 (386.95335388184): SELECT fid FROM jos_deeppockets WHERE id=294731360 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294731360 AND published='1' LIMIT 1

69 (37.193298339844): 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 (715.97099304199): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (201.94053649902): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (163.07830810547): 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 (409.12628173828): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (219.10667419434): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (211.95411682129): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (160.93254089355): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (126.12342834473): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (137.0906829834): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (123.02398681641): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (469.92301940918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (137.0906829834): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (37.193298339844): 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 (380.03921508789): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (171.89979553223): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (180.00602722168): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (137.0906829834): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 1032.829284668): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (176.90658569336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 7547.14012146): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

105 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

106 (488.0428314209): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (351.90582275391): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1311.0637664795): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

109 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

110 (108.00361633301): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (766.03889465332): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (850.91590881348): 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 (627.99453735352): 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 (966.07208251953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

115 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

116 (!!!!! 1189.2318725586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

117 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

118 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

119 (143.05114746094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

120 (560.04524230957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

121 (233.17337036133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

122 (!!!!! 2852.9167175293): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 56757.926940918): 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 (!!!!! 2940.8931732178): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731360 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731360 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (241.04118347168): ( 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 (53.167343139648): ( 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 (100.85105895996): 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 (81.062316894531): 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 (!!!!! 4338.9797210693): 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 (296.83113098145): 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 (41.961669921875): 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 (36.001205444336): 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 (236.98806762695): 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 (446.08116149902): 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 (!!!!! 1195.9075927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (794.1722869873): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (228.8818359375): SELECT name FROM jos_deeppockets WHERE id=213

138 (78.916549682617): SELECT name FROM jos_deeppockets WHERE id=213

139 (962.0189666748): 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 (526.90505981445): 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 (!!!!! 6750.8220672607): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

142 (!!!!! 1485.1093292236): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

143 (!!!!! 15008.926391602): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 6689.0716552734): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 3429.8896789551): 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=294731360 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1648.1876373291): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1744.9855804443): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

149 (944.85282897949): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

150 (!!!!! 3048.8967895508): 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 (!!!!! 7359.0278625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

152 (!!!!! 8118.1526184082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

153 (!!!!! 7843.9712524414): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731360 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731360 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 7824.182510376): 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 (!!!!! 8152.961730957): 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 (!!!!! 7598.1616973877): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 7911.205291748): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

158 (!!!!! 7513.9999389648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731360 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731360 AND published='1' LIMIT 1

159 (!!!!! 4016.8762207031): select jos_twitters.link from jos_twitters where cat=10

160 (765.08522033691): select jos_facebook.link from jos_facebook where cat=10

161 (243.9022064209): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 2351.9992828369): select jos_linkedin.link from jos_linkedin where cat=10

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