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Prostate Cancer Patients Treated Using Enhanced Seed Brachytherapy Software

By MedImaging International staff writers
Posted on 30 Apr 2009

Prostate cancer patients have begun receiving brachytherapy using new treatment planning software that enables improvements in the precision and speed of the treatment process.

VariSeed 8.0, developed by Varian Medical Systems (Palo Alto, CA, USA), is an updated version of the company's treatment planning software for low dose rate (LDR) brachytherapy in which radiation doses are delivered by implanting seeds within the prostate.

With VariSeed 8.0, clinicians can use the new software to target individual sectors of the prostate based on biopsy results, according to Rebecca Claydon, software product manager with Varian's brachytherapy business unit. "We have also speeded up the planning process considerably with an improved SeedFinder algorithm," Ms. Claydon said. "The use of a 3D digital reconstructed radiograph [three-dimensional DRR] generated from a CT [computed tomography] allows doctors to more easily see and interactively add or remove proposed seed locations from the treatment plan."

According to Dr. William Bice, recently from the University of Texas Health Science Center at San Antonio (USA) but now practicing at The London Clinic (UK), the main benefit of VariSeed 8.0 over previous versions of the product is its ability to perform sector analysis. "The new version of VariSeed features some significant improvements in several different areas, particularly the ability to target regions using sector analysis," said Dr. Bice. "It is now easier to verify seed locations following source localization and reconstruction using the projection display in VariSeed 8.0."

At Kuopio University Hospital (Finland), brachytherapy physicist Jan-Erik Palmgren performed his first treatment using VariSeed 8.0 in March. "The ease of calibration was excellent and we are evaluating the benefits of sector analysis," he said. "Permanent seed implants are becoming more common in Finland. This is a small country and patients are asking for it because their friends tell them about it. It's very easy for the patient and the treatment is outpatient-based."

"There are some really nice features with VariSeed 8.0 that aid identification and simplify dose planning," said Asa Jamtrot, medical physicist at Karolinska University's South Hospital (Stockholm, Sweden). Physicians at the hospital have treated between 6 and 10 patients using the new system to date.

"It's extremely important to make the planning as easy as possible, particularly when you are in the operating room," Ms. Claydon added. "Our customers have always liked the simple tabular flow of VariSeed, which makes the system so usable, and the new digital connection to BK Medical's Pro Focus scanner improves this workflow even more."

VariSeed 8.0 also offers brachytherapy physicists new and improved contouring tools, including the ability to contour in the sagittal and coronal planes. Contouring the urethra has been simplified by the introduction of the Structure sweep, which is also available in the VariSeed Implant View module for interactive seed placement and dosimetry. For postplanning, the updated system offers a tool that creates a digital reconstruction of the CT image and makes it much simpler to define the seed placement, which has been time-consuming in the past. A typical permanent seed implant involves up to 120 radioactive seeds, each the size of a grain of rice.

The use of permanent seed implants for LDR brachytherapy for early stage prostate cancer has increased in recent years. In this technique, radioactive seeds are positioned in the prostate using needles that are guided into position by ultrasound and a template or grid through which the needles are inserted to control their spacing. From 50 to more than 100 individual seeds may be placed in a single session, using 10 to 20 needles. The seeds or radiation sources then deliver the dose slowly over the following month.

There are more than 1,200 hospital sites worldwide using approximately 1,700 Varian VariSeed software systems for guiding the placement of permanent prostate seed implants in what is called LDR brachytherapy. Use of this technique alone or in combination with external beam radiotherapy is increasing for patients, including about 60,000, or one-third, of U.S. men who are diagnosed annually with prostate cancer.

Varian Medical Systems is a leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, proton therapy, and brachytherapy.

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59 (!!!!! 5530.1189422607): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

60 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

61 (!!!!! 9504.0798187256): 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 (!!!!! 2444.0288543701): SELECT fid FROM jos_deeppockets WHERE id=294723020 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294723020 AND published='1' LIMIT 1

63 (!!!!! 11383.056640625): 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=211 ORDER BY `ordering`

64 (!!!!! 7609.8442077637): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 7974.8630523682): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 7886.1713409424): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 7905.9600830078): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 7764.1010284424): SELECT fid FROM jos_deeppockets WHERE id=294723020 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294723020 AND published='1' LIMIT 1

69 (!!!!! 7922.887802124): 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=211 ORDER BY `ordering`

70 (!!!!! 7647.0375061035): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 7962.9421234131): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 7919.0731048584): 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 (449.89585876465): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (168.80035400391): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (154.01840209961): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (144.00482177734): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (150.91896057129): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (127.07710266113): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (134.94491577148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (483.03604125977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.901763916016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (164.98565673828): 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 (374.07875061035): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (164.98565673828): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (128.03077697754): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (169.99244689941): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (128.98445129395): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (164.98565673828): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (31.232833862305): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (146.15058898926): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (699.99694824219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

105 (174.04556274414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

106 (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.cat=10 AND dp.id=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 3232.0022583008): 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=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1756.9065093994): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

109 (156.16416931152): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

110 (184.05914306641): 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=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (658.03527832031): 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=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1391.1724090576): 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 (!!!!! 1705.1696777344): 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 (!!!!! 1559.9727630615): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

115 (!!!!! 2516.9849395752): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

116 (!!!!! 1845.8366394043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

117 (215.05355834961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

118 (262.02201843262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

119 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

120 (302.07633972168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

121 (422.00088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

122 (560.99891662598): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 85719.82383728): 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 (!!!!! 1222.1336364746): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723020 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723020 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (72.956085205078): ( 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 (59.843063354492): ( 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 (!!!!! 1441.9555664062): 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 (56.982040405273): 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 (262.97569274902): 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 (193.11904907227): 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 (303.03001403809): 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 (60.081481933594): 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 (380.9928894043): 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 (38.14697265625): 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 (783.92028808594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (344.99168395996): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (113.01040649414): SELECT name FROM jos_deeppockets WHERE id=211

138 (30.994415283203): SELECT name FROM jos_deeppockets WHERE id=211

139 (789.88075256348): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (531.19659423828): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (933.17031860352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

142 (388.14544677734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

143 (!!!!! 16708.135604858): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 4978.1799316406): 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=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 7482.0518493652): 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=294723020 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (471.83036804199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

149 (47.206878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

150 (!!!!! 1573.8010406494): 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 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

152 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

153 (36.954879760742): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723020 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723020 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 2159.8339080811): 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=211 or channel_id is null)

155 (159.97886657715): 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=211 or channel_id is null)

156 (319.00405883789): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 2815.0081634521): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

158 (!!!!! 3544.0921783447): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723020 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723020 AND published='1' LIMIT 1

159 (497.10273742676): select jos_twitters.link from jos_twitters where cat=10

160 (893.83125305176): select jos_facebook.link from jos_facebook where cat=10

161 (145.91217041016): select jos_google_plus.link from jos_google_plus where cat=10

162 (35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10

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