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Innovative Platform for CT Sets New Standards for Dose Reduction

By MedImaging International staff writers
Posted on 30 Dec 2010

A new technology platform for computed tomography (CT) scanners helps hospital staff to perform CT examinations faster and more efficiently than before as well as keeping the dose as low as possible.

The FAST CARE applications, from Siemens Healthcare (Erlangen, Germany) simplify workflows during scanning and in the preparation of image reconstructions. Patients benefit from lower radiation doses and shorter examination times as the system automates many operating procedures, suggests parameter settings for image quality and dose reduction, and standardizes processes that makes results more readily reproducible. These enhancements help CT operators and service providers improve their productivity. FAST CARE will be available on the Somatom Definition AS scanners in March 2011, and on the Somatom Definition Flash scanners in May 2011. Somatom Definition product family CT scanners that are already on the market can be upgraded to the new platform.

Two of the key current needs in CT for which Siemens has developed FAST CARE are optimization of the processes relating to patient diagnostic examinations and reducing the doses necessary for such examinations. The new technology platform's applications therefore focus on two aspects: Fully Assisting Scanner Technologies (FAST) support process optimization and Combined Applications to Reduce Exposure (CARE) assist with dose reduction.

The FAST technologies simplify and automate time-consuming and complex procedures in computed tomography. This improves not only the workflows, but also the results: as they make it easier to operate the equipment and to reproduce results. The FAST functions support doctors and radiology technologists at every step of a CT examination, from planning and image acquisition to reconstruction and diagnosis of the images. The major feature is that the anatomy of the individual patient is automatically taken into account.

The most important applications in this family include FAST Planning for standardized determination of the correct scan and reconstruction areas. FAST Cardio Wizard offers step-by-step instructions in the user interface to help operators gain practice in the complex preparations for cardiac examinations. FAST Scan Assistant and FAST Adjust determine the appropriate parameters for performing CT examinations with the best possible image quality. FAST Spine can reduce the work of preparing for spine reconstructions, resulting in considerable timesavings. With just a single click, the operator can select the desired region of the spine from a list of typical predefined scan regions. FAST Spine then determines the correct position of the planes to be reconstructed and identifies all vertebrae and intervertebral discs accordingly. This results in considerable timesavings, particularly with emergency patients, and can enhance the therapeutic safety of interventions.

When used in combination with syngo.via, the software platform for diagnosing clinical images from Siemens, FAST CARE optimizes the entire examination process, as it brings together all the steps involved, from scan preparation and performance through image reconstruction to diagnosis, in a single integrated solution.

From the patient's point of view, however, it is not enough just to improve the processes-- administering the lowest possible dose is just as important. In CT, a large amount of importance is rightly attached to the Alara principle (as low as reasonably achievable). Along with its FAST applications, Siemens CT delivers a comprehensive range of new CARE applications for dose reduction. These include, for example, automatic display of the dose distribution for the planned examination using CARE Profile. The CARE Dashboard shows the operators the activated dose reduction functions, so that they can then further optimize the examination protocols and scan parameters.

In essence, it is possible to improve the image quality significantly and at the same time to optimize the dose by selecting the correct kV level for the CT for the particular patient and organ involved. If the tube voltage is altered, however, all the other scan parameters also have to be adjusted accordingly. But as the dependencies are not linear, the values must currently be calculated manually using complex formulae. Studies have shown that for this reason, operators do not usually alter kV values and thus do not exploit the full potential for dose reduction. Siemens is providing an answer to this problem for the first time: CARE kV suggests the correct tube voltage depending on the patient's anatomy and the organ to be examined. All other parameters are automatically adjusted to suit the selected kV level. This optimizes the contrast-to-noise ratio in the image and allows reduction of the dose by up to 60%.

While voltages typically used today lie between 80 kV and 140 kV, with CARE Child CT examinations can be performed using just 70 kV, significantly reducing dose levels. This achievement has been made possible by Siemens' development of its Straton tube, enabling it to produce this low voltage.

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59 (115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

60 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

61 (108.95729064941): 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 (505.92422485352): SELECT fid FROM jos_deeppockets WHERE id=294732740 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732740 AND published='1' LIMIT 1

63 (311.13624572754): 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 (72.956085205078): select jos_twitters.link from jos_twitters where cat=10

65 (46.014785766602): select jos_facebook.link from jos_facebook where cat=10

66 (51.975250244141): select jos_google_plus.link from jos_google_plus where cat=10

67 (43.153762817383): select jos_linkedin.link from jos_linkedin where cat=10

68 (95.129013061523): SELECT fid FROM jos_deeppockets WHERE id=294732740 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732740 AND published='1' LIMIT 1

69 (74.863433837891): 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 (411.03363037109): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (308.99047851562): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1368.9994812012): 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 (74.863433837891): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (90.122222900391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (82.015991210938): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (43.869018554688): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.007995605469): 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 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

105 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

106 (50.783157348633): 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (49.114227294922): 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

109 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (571.01249694824): 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (769.85359191895): 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 (451.08795166016): 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 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

115 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

116 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

117 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

118 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

120 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

121 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

122 (298.97689819336): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 20887.136459351): 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 (491.14227294922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732740 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732740 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7372.1408843994): ( 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 (139.95170593262): ( 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 (308.99047851562): 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 (110.86463928223): 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 (226.97448730469): 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 (51.021575927734): 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 (219.10667419434): 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 (75.101852416992): 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 (192.16537475586): 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 (73.909759521484): 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 (612.02049255371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (430.10711669922): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (346.89903259277): SELECT name FROM jos_deeppockets WHERE id=211

138 (65.803527832031): SELECT name FROM jos_deeppockets WHERE id=211

139 (765.08522033691): 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 (674.96299743652): 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 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

142 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

143 (!!!!! 11883.974075317): TRUNCATE TABLE jos_trademed_module

144 (123.02398681641): 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (60.081481933594): 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=294732740 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (611.0668182373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

149 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

150 (!!!!! 1441.0018920898): 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 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

152 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

153 (43.153762817383): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732740 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732740 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (50.067901611328): 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 (45.061111450195): 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 (50.067901611328): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

158 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732740 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732740 AND published='1' LIMIT 1

159 (94.890594482422): select jos_twitters.link from jos_twitters where cat=10

160 (32.901763916016): select jos_facebook.link from jos_facebook where cat=10

161 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

162 (32.186508178711): select jos_linkedin.link from jos_linkedin where cat=10

163 (323.05717468262): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1397.1328735352): insert into jos_banners_delta values (14615,'2025-08-20 14:48:48','216.73.216.0','view'),(14202,'2025-08-20 14:48:48','216.73.216.0','view'),(14203,'2025-08-20 14:48:48','216.73.216.0','view')

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