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SPECT/PET Image of the Year Shows Parathyroid Disease in Greater Detail

By MedImaging International staff writers
Posted on 27 Jul 2010

Image: The Society of Nuclear Medicine’s Image of the Year (Photo courtesy of SNM).

Research shows that molecular imaging fusion with high-resolution computed tomography (CT) anatomy may result in precise localization of parathyroid lesions.

The Society of Nuclear Medicine's (SNM; Reston, VA, USA) 2010 Image of the Year shows the potential of hybrid molecular imaging to provide precise information about the location and function of a condition known as hyperparathyroidism. Researchers selected this image from more than 1,500 studies presented over the course of four days during SNM's 57th annual meeting in June 2010 in Salt Lake City (UT, USA).

"Each year, SNM chooses an image that exemplifies the most cutting-edge molecular imaging research today, as well as illustrates the potential of molecular imaging to provide physicians with a critical component for the detection and diagnosis of disease,” said Michael M. Graham, Ph.D., M.D., immediate past-president of SNM. "This year's Image of the Year provides an example of a novel imaging presentation, using a combination of single photon emission computed tomography [SPECT] with high-resolution CT angiography, which pinpoints the abnormally functioning parathyroid adenoma and the arteries feeding it. With this information, physicians may be able determine the exact location and size of the abnormal gland and plan minimally invasive surgery that reduces operative time, thus improving patient care.”

The SNM Image of the Year shows the potential of fusion of high-resolution three-dimensional (3D) anatomy with functional SPECT images to provide critical information to help physicians to diagnose and treat hyperparathyroidism, an endocrine disease that occurs when the parathyroid glands develop a small adenoma, a benign tumor that produces too much hormone and causes high levels of calcium in the blood. It is usually treated by invasive, exploratory surgery. Using fusion images, physicians can obtain detailed information about the anatomical localization, blood supply, and metabolism of the overactive parathyroid adenoma.

In this study, researchers, from Hokko Memorial Hospital (Sapporo, Japan), scanned 31 patients with symptoms of primary hyperparathyroidism using a nuclear medicine technique called MIBI (methoxyisobutyl isonitrile), combined with SPECT and multidetector computed tomography (MDCT). Researchers obtained thin-slice multiplanar reconstruction images of the neck using a 64-row MDCT with contrast enhancement.

When the enlarged gland was successfully identified, volume-rendered images of the thyroid and parathyroid with feeding arteries were generated. Then, two- and three-dimensional fusion images were also obtained using dedicated workstations. The diagnostic value of three-dimensional SPECT/CT fusion images was compared with those by MIBI SPECT alone and by ultrasound. The study revealed that the hybrid molecular imaging technique was more effective than single modality scanning alone.

A total of 34 glands were identified by surgery. SPECT/CT fusion image, MIBI SPECT, and ultrasound identified 32 (94%), 27 (79%), and 27 (79%) adenomas, respectively. The fusion imaging technique identified five glands that were missed by ultrasound and MIBI SPECT. The fusion images successfully revealed feeding arteries in 29 adenomas. With the use of fusion images for navigation, preliminary results in eight patients showed that operation time is decreased by approximately 82% compared to studies performed without fusion images.

According to the U.S. National Institutes of Health (Bethesda, MD, USA), approximately 100,000 Americans develop hyperparathyroidism each year. Women outnumber men two to one, and risk increases with age. In women 60 years and older, two out of 1,000 will develop hyperparathyroidism each year.

SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today's medical practice that adds an additional level to diagnosis, changing the way common and debilitating diseases are understood and treated.

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59 (!!!!! 4575.9677886963): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

60 (306.84471130371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

61 (!!!!! 9598.0167388916): 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 (!!!!! 4179.9545288086): SELECT fid FROM jos_deeppockets WHERE id=294730429 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294730429 AND published='1' LIMIT 1

63 (!!!!! 1074.0756988525): 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 (191.92695617676): select jos_twitters.link from jos_twitters where cat=10

65 (402.92739868164): select jos_facebook.link from jos_facebook where cat=10

66 (51.021575927734): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

68 (145.91217041016): SELECT fid FROM jos_deeppockets WHERE id=294730429 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294730429 AND published='1' LIMIT 1

69 (349.99847412109): 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 (351.90582275391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (686.8839263916): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (39.815902709961): 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 (534.0576171875): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (62.942504882812): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (139.95170593262): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (395.05958557129): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (105.14259338379): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (361.91940307617): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 3957.986831665): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (164.03198242188): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (79.154968261719): 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 (482.08236694336): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (184.05914306641): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (605.82160949707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

105 (126.12342834473): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

106 (!!!!! 9299.9935150146): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1235.9619140625): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 7194.995880127): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

109 (!!!!! 2992.1531677246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

110 (!!!!! 5445.0035095215): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 3300.9052276611): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1059.0553283691): 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 (641.82281494141): 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 (583.88710021973): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

115 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

116 (581.02607727051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

117 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

118 (408.17260742188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

119 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

120 (422.95455932617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

121 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

122 (640.1538848877): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 47150.850296021): 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 (804.18586730957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294730429 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294730429 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (46.014785766602): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (36.001205444336): ( 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 (216.96090698242): 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 (36.001205444336): 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 (202.17895507812): 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 (162.12463378906): 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 (34.093856811523): 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 (150.91896057129): 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 (36.001205444336): 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 (132.08389282227): 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 (!!!!! 1816.0343170166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 7944.1070556641): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (431.06079101562): SELECT name FROM jos_deeppockets WHERE id=211

138 (39.815902709961): SELECT name FROM jos_deeppockets WHERE id=211

139 (591.99333190918): 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 (!!!!! 1516.1037445068): 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 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

142 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

143 (!!!!! 16503.095626831): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 8471.9657897949): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 3804.2068481445): 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=294730429 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2433.7768554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 2093.0767059326): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

149 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

150 (!!!!! 4965.06690979): 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 (!!!!! 3751.0395050049): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

152 (333.07075500488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

153 (248.90899658203): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294730429 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294730429 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (674.00932312012): 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 (630.14030456543): 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 (97.036361694336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 4857.063293457): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

158 (!!!!! 3981.1134338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294730429 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294730429 AND published='1' LIMIT 1

159 (79.154968261719): select jos_twitters.link from jos_twitters where cat=10

160 (44.107437133789): select jos_facebook.link from jos_facebook where cat=10

161 (41.961669921875): select jos_google_plus.link from jos_google_plus where cat=10

162 (205.99365234375): select jos_linkedin.link from jos_linkedin where cat=10

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