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Molecular Breast Imaging May Be Better Than Ultrasound and Mammography for Breast Cancer Detection

By MedImaging International staff writers
Posted on 20 Feb 2012

Molecular breast imaging (MBI), also known as breast-specific gamma imaging (BSGI), can detect tumors often overlooked by the two most common breast imaging modalities, mammography and ultrasound.

In a recent study, BSGI had the highest overall sensitivity (91%) for breast cancer detection, significantly higher than that of mammography and ultrasound, 74% and 84%, respectively. Moreover, BSGI was more effective than ultrasound in contributing to patient management when the findings of these studies altered the diagnosis provided by mammography.

In this multicenter study of 1042 patients at four institutions, published January 2012 in the American Journal of Roentgenology (AJR), BSGI had an outstanding overall sensitivity of 91% and negative predictive value (NPV) of 96%. The BSGI procedures were performed with a high-resolution gamma camera, the Dilon 6800. For patients who had adjunctive imaging scanning with results discordant from those for mammography, BSGI provided higher diagnostic accuracy than ultrasound (77% vs. 35%). The group of patients with indeterminate mammograms (BI-RADS 0) received the greatest benefit from use of BSGI. For the BI-RADS 0 patients, BSGI was considerably more likely to contribute to patient management than ultrasound, it was less likely to be negative in cancerous lesions, and was less likely to be positive in benign lesions. Interestingly 85% of the patients included in this study had dense breast tissue.

The lead author, Dr. Jean M. Weigert, a radiologist at Bradley Memorial Hospital (New Britain, CT, USA), commented that, “BSGI continuously proves to be a very important diagnostics tool in our facility. In the recently published article BSGI indicated a change in patient management for a greater number of patients, and was typically more effective than ultrasound because of improved specificity and positive predictive values.”

Ultrasound does not involve an exposure to radiation. BSGI involves the injection of a dose to the patient that is comparable with or lower than that of other diagnostic imaging procedures. According to RadiologyInfo.org, a website codeveloped by the American College of Radiology (Reston, VA, USA) and Radiological Society of North America (Oak Brook, IL, USA), “[...] there are no known long-term adverse effects from such low-dose exposure.” Similar to mammography, the benefits of BSGI greatly outweigh the risks due to radiation exposure.

As a follow-up to mammography, BSGI/MBI utilizes the Dilon 6800 gamma camera to help clinicians more precisely differentiate benign from malignant tissue. To perform BSGI/MBI, the patient receives a pharmaceutical tracing agent that is absorbed by all the cells in the body. Because of their increased rate of metabolic activity, cancerous cells in the breast absorb a greater amount of the tracing agent than normal healthy cells and typically appear as dark spots on the BSGI/MBI image.

Dilon Diagnostics’ (Newport News, VA, USA) a brand of Dilon Technologies Inc.) cornerstone product, the Dilon 6800, is a high-resolution, small field-of view gamma camera, optimized to perform BSGI/MBI, a molecular breast imaging procedure that images the metabolic activity of breast lesions through radiotracer uptake.

Related Links:
Bradley Memorial Hospital
Dilon Diagnostics

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61 (82.969665527344): 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 (615.83518981934): SELECT fid FROM jos_deeppockets WHERE id=294739352 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294739352 AND published='1' LIMIT 1

63 (428.91502380371): 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 (61.03515625): select jos_twitters.link from jos_twitters where cat=10

65 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

66 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

67 (27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10

68 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294739352 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294739352 AND published='1' LIMIT 1

69 (33.140182495117): 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 (365.9725189209): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (241.99485778809): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.908554077148): 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 (!!!!! 5188.9419555664): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (110.14938354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (80.108642578125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (42.200088500977): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (46.968460083008): 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 (79.870223999023): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (!!!!! 4138.9465332031): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (108.95729064941): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): 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 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (122.0703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

105 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

106 (73.909759521484): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (660.18104553223): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

109 (142.81272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

110 (77.009201049805): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (684.97657775879): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (797.98698425293): 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 (!!!!! 3203.8688659668): 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 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

115 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

116 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

117 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

118 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

120 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 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 (!!!!! 48599.004745483): 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 (666.85676574707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739352 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739352 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 19055.128097534): ( 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 (83.92333984375): ( 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 (66.041946411133): 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 (45.061111450195): 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 (64.13459777832): 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 (46.014785766602): 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 (401.02005004883): 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 (51.021575927734): 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 (46.968460083008): 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 (39.100646972656): 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 (!!!!! 1989.8414611816): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (470.87669372559): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (408.88786315918): SELECT name FROM jos_deeppockets WHERE id=213

138 (38.14697265625): SELECT name FROM jos_deeppockets WHERE id=213

139 (619.88830566406): 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 (755.07164001465): 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 (!!!!! 6220.1023101807): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

142 (95.129013061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

143 (!!!!! 8162.0216369629): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1646.9955444336): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (102.99682617188): 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=294739352 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1266.9563293457): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1902.1034240723): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

149 (!!!!! 1502.9907226562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

150 (!!!!! 1794.0998077393): 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 (647.06802368164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

152 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

153 (!!!!! 2526.9985198975): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739352 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739352 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (808.0005645752): 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 (41.961669921875): 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 (550.0316619873): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 1194.0002441406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

158 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739352 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739352 AND published='1' LIMIT 1

159 (473.97613525391): select jos_twitters.link from jos_twitters where cat=10

160 (55.074691772461): select jos_facebook.link from jos_facebook where cat=10

161 (41.007995605469): select jos_google_plus.link from jos_google_plus where cat=10

162 (38.862228393555): select jos_linkedin.link from jos_linkedin where cat=10

163 (!!!!! 1872.0626831055): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1167.0589447021): insert into jos_banners_delta values (14615,'2025-06-21 04:43:33','216.73.216.120','view'),(14202,'2025-06-21 04:43:33','216.73.216.120','view'),(14203,'2025-06-21 04:43:33','216.73.216.120','view')

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