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PET/CT Better Than Traditional Staging for Locally Advanced Breast Cancer Patients

By MedImaging International staff writers
Posted on 17 Jan 2013

French researchers have revealed that 18F-fludeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging provides considerable prognostic stratification data at initial staging for patients with locally advanced breast cancer. When compared to conventional imaging, 18F-FDG PET/CT more effectively demonstrated lesions in the abdomen, chest, and bones in only one session, altering management for more than 50% of the patients in the study.

The study’s findings were published in the January 2013 issue of the Journal of Nuclear Medicine. Guidelines from the US National Comprehensive Cancer Network (NCCN) recommend a physical exam, bilateral mammogram, ultrasound, or breast magnetic resonance imaging (MRI) to assess the breast, as well as chest diagnostic CT, abdominal, or pelvic diagnostic CT or MR imaging and bone scanning for the assessment of distant involvement. The NCCN guidelines deem 18F-FDG PET/CT to be “most helpful in situations where standard staging studies are equivocal or suspicious.”

“The prognosis of patients with locally advanced breast cancer remains poor. In this study we aimed to investigate whether the use of 18F-FDG PET/CT at initial staging could have an impact on the prognostic stratification and management of patients with locally advanced breast cancer," said David Groheux, MD, PhD, from the department of nuclear medicine, Saint-Louis Hospital (Paris, France), and lead author of the study.

One hundred and seventeen patients with locally advanced breast cancer were prospectively included in the study over a course of five years. Patients underwent conventional imaging methods, including bone scanning, chest radiography, or dedicated CT and abdominopelvic examination by ultrasound or contrast-enhanced CT and were staged accordingly. They then received an 18F-FDG PET/CT scan, which was reviewed by nuclear medicine specialists with no knowledge of the conventional imaging results. The conventional imaging and 18F-FDG imaging results were then compared.

All primary tumors were detected by 18F-FDG PET/CT. The scans validated lymph node involvement in stage IIIC patients and revealed unanticipated lymph node involvement in 32 additional patients. Moreover, distant metastases (bone, distant lymph nodes, liver, lung, and pleura) were visualized with 18F-FDG PET/CT in 43 patients; conventional imaging only identified 28 patients with distant metastases. Overall, 18F-FDG PET/CT changed the stage of 61 out of 117 patients, which then affected the recommended treatment for the patients.

“This is a step toward the truly personalized medicine that molecular imaging can bring—acquiring an image that provides sufficient information to truly tailor management strategies to the singular needs of each patient,” noted Dr. Groheux. “Based on these findings, 18F-FDG PET/CT may become the single most important distant staging modality in patients with locally advanced breast cancer.”

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63 (!!!!! 1368.9994812012): 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 (!!!!! 1468.8968658447): select jos_twitters.link from jos_twitters where cat=10

65 (603.91426086426): select jos_facebook.link from jos_facebook where cat=10

66 (494.95697021484): select jos_google_plus.link from jos_google_plus where cat=10

67 (213.8614654541): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 1618.8621520996): SELECT fid FROM jos_deeppockets WHERE id=294744309 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294744309 AND published='1' LIMIT 1

69 (788.21182250977): 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 (!!!!! 3497.1237182617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (885.96343994141): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (501.15585327148): 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 (900.0301361084): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (158.07151794434): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (768.18466186523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (160.93254089355): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (382.1849822998): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (169.03877258301): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (341.89224243164): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (145.19691467285): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (809.90791320801): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (133.99124145508): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (969.17152404785): 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 (!!!!! 7534.0270996094): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (!!!!! 7946.0144042969): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 7896.900177002): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (!!!!! 7955.0743103027): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (!!!!! 7595.0622558594): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (!!!!! 4850.1491546631): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (!!!!! 4744.0528869629): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 3153.0857086182): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (!!!!! 7845.1633453369): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 3978.967666626): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (!!!!! 7899.9996185303): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (!!!!! 10159.015655518): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (!!!!! 5695.8198547363): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (!!!!! 7993.9365386963): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 7405.9963226318): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

105 (!!!!! 7990.1218414307): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

106 (!!!!! 8056.1637878418): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 4773.1399536133): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 11137.008666992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

109 (!!!!! 7960.0811004639): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

110 (!!!!! 8116.9605255127): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 7874.0119934082): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 7928.8482666016): 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 (!!!!! 10313.987731934): 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 (!!!!! 7300.1384735107): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

115 (235.79597473145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

116 (!!!!! 3391.0274505615): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

117 (170.94612121582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

118 (!!!!! 1558.0654144287): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

119 (197.17216491699): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

120 (658.98895263672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

121 (154.01840209961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

122 (!!!!! 4729.0325164795): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 116395.95031738): 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 (!!!!! 7616.9967651367): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 54211.139678955): ( 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 (!!!!! 1930.9520721436): ( 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 (666.14151000977): 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 (551.93901062012): 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 (!!!!! 1104.1164398193): 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 (321.86508178711): 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 (426.05400085449): 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 (333.07075500488): 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 (542.87910461426): 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 (277.04238891602): 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 (!!!!! 8881.0920715332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 1523.0178833008): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (77.962875366211): SELECT name FROM jos_deeppockets WHERE id=213

138 (46.014785766602): SELECT name FROM jos_deeppockets WHERE id=213

139 (!!!!! 1301.0501861572): 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 (!!!!! 1880.8841705322): 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 (768.89991760254): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

142 (!!!!! 3006.9351196289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

143 (!!!!! 10257.005691528): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 14178.991317749): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (904.79850769043): 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=294744309 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2566.0991668701): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 1801.0139465332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (257.96890258789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

149 (468.01567077637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

150 (!!!!! 6916.9998168945): 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 (!!!!! 1004.9343109131): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

152 (473.97613525391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

153 (842.09442138672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294744309 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (62.942504882812): 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 (46.968460083008): 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 (427.9613494873): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (224.11346435547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

158 (450.13427734375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294744309 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294744309 AND published='1' LIMIT 1

159 (341.89224243164): select jos_twitters.link from jos_twitters where cat=10

160 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

161 (92.029571533203): select jos_google_plus.link from jos_google_plus where cat=10

162 (76.055526733398): select jos_linkedin.link from jos_linkedin where cat=10

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