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Lung Cancer Detection Using CT Scanning More Successful Than Traditional Methods

By MedImaging International staff writers
Posted on 19 Apr 2012

New research indicates that computed tomography (CT) scans are more effective than conventional lung cancer-detection techniques at identifying aggressive lung cancer in their most treatable stages.

The study’s findings, published online April 2012 in the journal Radiology, demonstrate that lung cancers found through yearly CT screening are similar to those found in routine practice, both in terms of tumor growth rates and cell-type distribution. In fact, the report revealed that 79% of the cases diagnosed through annual repeat CT scans were detected at clinical stage I, the earliest and most treatable stage, compared to only 15% detected through traditional methods.

The study, which is the latest report from the International Early Lung Cancer Action Program (I-ELCAP; Tempe, AZ, USA), counteracts concerns that lung cancers diagnosed through annual repeat rounds of computed tomography (CT) screening may be of less serious forms than those diagnosed in traditional clinical settings when symptoms are already present.

“We’ve previously shown that, similar to common screening methods such as mammography for breast cancer, annual CT scans are effective in early detection of lung cancer. However, there were concerns that the cancer found in these screenings were less serious than those found in routine practice in the clinical setting, and often resulted in excessive treatment,” said Claudia I.

Henschke, PhD, MD, a professor of radiology at Mount Sinai School of Medicine (New York, NY, USA) and I-ELCAP lead investigator. “However, the data show that lung cancers detected with annual repeat rounds of CT scans are just as lethal and require equally aggressive treatment.”

I-ELCAP is an international collaborative group of more than 60 participating institutes consisting of specialists on lung cancer-related diseases. Earlier studies from the group found that lung cancers identified through CT screening have an 80% cure rate compared to a 10% cure rate for lung cancers detected in the clinical setting.

“Lung cancer is by far the leading cause of cancer death among both men and women. However, when lung cancer is caught in an early, treatable stage, the cure rates are significantly higher,” said Dr. Henschke. “It is recommended that people at high risk for lung cancer speak with their health care provider to discuss the benefits and risks of screening in order to make an informed decision about enrolling in a screening program.”

For this study, the researchers reviewed pooled results from the I-ELCAP database for 1993 to 2009, consisting of men and women at risk for lung cancer who underwent annual repeat rounds of CT screening. Researchers found 111 cases of lung cancer, 90 of which were non-small-cell cancers. Out of the 111 cases, 79% were clinical stage I, the earliest and most treatable stage. Non-small-cell lung cancer is the most common form of lung cancer.

The researchers then compared their findings to a 2008 study published in the Journal of Thoracic Oncology analyzing the growth rates of non-small-cell lung cancers detected through traditional methods. The 2008 study found that only about 15% of those cancers were discovered in stage I.

The researchers also discovered that while the first round of CT screening detected a higher proportion of slower-growing cancers than those detected in clinical practice, the subsequent annual repeat rounds of screening reflected what is found in clinical practice.

The investigators then analyzed volume doubling time (growth rate) and cell-type distribution of the cancers. The mean volume doubling time for all cases was 136 days. Volume doubling times for lung cancers diagnosed in clinical practice ranged from 20 to 360 days. For the 90 non-small-cell cancers, mean volume doubling time was 154 days compared to 135 days in the 2008 study.

When researchers evaluated the cell-types of the cancers, they discovered that the frequencies of small-cell carcinoma, which typically develops in the central areas of the lung, and adenocarcinoma, usually located on the outer surface of the lungs, to be approximately 19% and 50%, respectively. In the 2008 study, these frequencies were nearly identical, at 20% and 50%.

Moreover, the researchers found that 89% of the tumors that manifested as solid nodules had considerably faster volume doubling times than the subsolid nodule cancers and may need a less aggressive diagnosis and treatment approach. The researchers defined cancerous nodules as solid if they obscured all of the lung tissue and sub-solid if they did not.

“Identifying the varying growth rates for specific lesion types should allow us to create a more tailored treatment for the patient,” concluded Dr. Henschke.

Related Links:
International Early Lung Cancer Action Program
Mount Sinai School of Medicine

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59 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

60 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

61 (99.897384643555): 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 (631.09397888184): SELECT fid FROM jos_deeppockets WHERE id=294740276 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294740276 AND published='1' LIMIT 1

63 (472.06878662109): 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 (47.206878662109): select jos_twitters.link from jos_twitters where cat=10

65 (32.901763916016): select jos_facebook.link from jos_facebook where cat=10

66 (32.186508178711): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (32.901763916016): SELECT fid FROM jos_deeppockets WHERE id=294740276 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294740276 AND published='1' LIMIT 1

69 (31.948089599609): 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 (279.18815612793): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (234.84230041504): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1038.0744934082): 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 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): 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 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (83.92333984375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (36.954879760742): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (46.014785766602): 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 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

105 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

106 (58.889389038086): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (47.922134399414): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

109 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

110 (46.014785766602): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (513.07678222656): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (572.91984558105): 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 (359.05838012695): 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 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

116 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

117 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

118 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

120 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

121 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

122 (366.9261932373): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 63378.095626831): 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 (!!!!! 11897.087097168): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740276 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740276 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 23999.929428101): ( 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 (74.148178100586): ( 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 (440.12069702148): 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 (44.107437133789): 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 (247.00164794922): 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 (36.954879760742): 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 (210.04676818848): 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 (36.001205444336): 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 (304.9373626709): 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 (57.220458984375): 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 (617.02728271484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (455.14106750488): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (306.12945556641): SELECT name FROM jos_deeppockets WHERE id=211

138 (56.982040405273): SELECT name FROM jos_deeppockets WHERE id=211

139 (827.07405090332): 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 (706.19583129883): 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 (!!!!! 2965.9271240234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

142 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

143 (!!!!! 19110.918045044): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1835.1078033447): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (764.84680175781): 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=294740276 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (612.97416687012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 1312.9711151123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (149.96528625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

149 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

150 (!!!!! 2664.0892028809): 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 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

152 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

153 (85.115432739258): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294740276 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294740276 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 2825.9754180908): 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 (144.00482177734): 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 (92.029571533203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (972.98622131348): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

158 (415.08674621582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294740276 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294740276 AND published='1' LIMIT 1

159 (!!!!! 1176.118850708): select jos_twitters.link from jos_twitters where cat=10

160 (108.00361633301): select jos_facebook.link from jos_facebook where cat=10

161 (52.928924560547): select jos_google_plus.link from jos_google_plus where cat=10

162 (51.021575927734): select jos_linkedin.link from jos_linkedin where cat=10

163 (!!!!! 6956.8157196045): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1246.9291687012): insert into jos_banners_delta values (14615,'2025-08-19 21:03:34','216.73.216.0','view'),(14202,'2025-08-19 21:03:34','216.73.216.0','view'),(14203,'2025-08-19 21:03:34','216.73.216.0','view')

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