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First Multicenter Trial Confirms Effectiveness of Combined CT Angiography and Myocardial Perfusion Imaging Using 320-Detector Row CT

By MedImaging International staff writers
Posted on 19 Sep 2012

Combined noninvasive computed tomography coronary angiography (CTA) and myocardial perfusion (CTP) with 320-detector row CT allows accurate identification of flow-limiting lesions requiring revascularization. More...

These are the key findings of the first worldwide multicenter trial evaluating the diagnostic performance of combined CTA and CTP as compared to the conventional evaluation of flow-limiting stenosis by means of single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) and invasive coronary angiography (ICA).

The trial’s findings, CORE320, sponsored by Toshiba Medical Systems Corp. (Tokyo, Japan), were presented in Munich (Germany) August 25-29, 2012, during an European Society of Cardiology (ESC) Hotline Session by Dr. João A. C. Lima, MD, senior author of the study and professor of medicine and radiology at the Johns Hopkins University School of Medicine (Baltimore, MD, USA).

“The CORE 320 study is the first prospective, multicenter study to examine the diagnostic accuracy of CT for assessing blockages in blood vessels and determining which of those blockages may be preventing the heart from getting adequate blood flow. We found an excellent correlation in results when we compared the 320-detector CT testing with the traditional means of assessment using a stress test with imaging and cardiac catheterization” said Dr. Lima.

Three hundred eighty-one patients completed all imaging and were included in the primary analysis. The patient-based diagnostic accuracy (AUC) of combined CTA and CTP for detecting or excluding flow-limiting cornary artery disease (CAD) without history of CAD was 0.93 when the ICA stenosis reference standard was 50%. CTP increased the diagnostic accuracy of CTA alone to delineate flow-limiting disease (AUC: 0.87 vs. 0.81, respectively, p < 0.001). The combination of CTA and CTP had similar diagnostic power to the combination of ICA and SPECT-MPI in identifying revascularized patients at 30 days.

The researchers say the two modalities combined--CTA and CTP--still generate less radiation than a cardiac scan with the 64-slice CT scanner in widespread use today. Dr. Lima stated, “In our study, the amount of radiation exposure to patients from the two 320-slice CT scanner tests was half the amount they received as a result of the traditional evaluation methods--the angiogram and nuclear medicine stress test combined.”

The unique ability of Aquilion One, the dynamic volume CT system used in CORE320, which acquires the entire heart in a single temporally uniform volume, permits accurate myocardial perfusion analysis. The perfusion technique developed for Aquilion One provides perfusion images at the lowest possible radiation dose when AIDR (adaptive iterative dose reduction three-dimensional [3D]) reconstruction, is applied.

“One of Toshiba’s core missions is to validate its technology through clinical trials by leaders in the medical field,” explained Satoshi Tsunakawa, president of Toshiba Medical Systems Corp. “CORE320 has shown that it is now possible to perform a comprehensive cardiac functional and morphological analysis in just one, low-dose examination using Aquilion One. This technology can reduce the need to perform multiple examinations using different modalities, a true economical advantage and valuable contribution in cardiac healthcare,” said Mr. Tsunakawa.

The Aquilion Onesystem, in conjunction with myocardial perfusion software available on the VitreafX and Vitrea Enterprise Suite, includes all the features used for CORE 320 data acquisition and analysis, allowing physicians to perform myocardial perfusion imaging in their institution today.

“Training is another essential part of Toshiba’s myocardial perfusion solution,” said Tsunakawa. To assist physicians in implementing myocardial perfusion into their clinical practice, Toshiba is sponsoring the Myocardial Perfusion CT Workshops held at Rigshospitalet in Copenhagen (Denmark). Dr Klaus Kofoed, the co-program director, participated in CORE320 and brings a wealth of experience from the trial to all attendees.

Related Links:
Toshiba Medical Systems
Johns Hopkins University School of Medicine

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57 (611.0668182373): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

58 (!!!!! 1893.0435180664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

59 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

60 (197.8874206543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

61 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

62 (182.8670501709): 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

63 (647.78327941895): SELECT fid FROM jos_deeppockets WHERE id=294742583 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294742583 AND published='1' LIMIT 1

64 (75.101852416992): 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`

65 (75.101852416992): select jos_twitters.link from jos_twitters where cat=10

66 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

67 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

68 (63.896179199219): select jos_linkedin.link from jos_linkedin where cat=10

69 (57.93571472168): SELECT fid FROM jos_deeppockets WHERE id=294742583 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294742583 AND published='1' LIMIT 1

70 (44.822692871094): 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`

71 (486.13548278809): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (398.87428283691): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (65.803527832031): 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`

74 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (80.108642578125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (44.107437133789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (45.7763671875): 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`

91 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (140.90538024902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

106 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

107 (103.95050048828): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (85.115432739258): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

110 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

111 (78.916549682617): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (777.9598236084): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (920.05729675293): 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 (711.91787719727): 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

115 (206.94732666016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

116 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

117 (111.81831359863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

118 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

119 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

120 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

121 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

122 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

123 (509.97734069824): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

124 (!!!!! 30889.03427124): 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

125 (810.14633178711): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742583 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742583 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (!!!!! 11878.01361084): ( 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 (135.89859008789): ( 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

128 (81.062316894531): 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 (45.061111450195): 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

130 (81.062316894531): 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 (45.061111450195): 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

132 (570.05882263184): 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 (63.180923461914): 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

134 (54.836273193359): 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 (45.061111450195): 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

136 (604.15267944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (380.9928894043): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (47.922134399414): SELECT name FROM jos_deeppockets WHERE id=211

139 (39.100646972656): SELECT name FROM jos_deeppockets WHERE id=211

140 (794.88754272461): 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 (767.94624328613): 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

142 (122.7855682373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

143 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

144 (!!!!! 14378.070831299): TRUNCATE TABLE jos_trademed_module

145 (98.943710327148): 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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (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_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=294742583 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (838.04130554199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

150 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

151 (!!!!! 1657.9627990723): 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

152 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

153 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

154 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294742583 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294742583 AND type='deeppockets_item' AND published='1' LIMIT 1

155 (36.001205444336): 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 (32.901763916016): 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)

157 (36.954879760742): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

158 (171.89979553223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

159 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294742583 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294742583 AND published='1' LIMIT 1

160 (58.889389038086): select jos_twitters.link from jos_twitters where cat=10

161 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

162 (56.982040405273): select jos_google_plus.link from jos_google_plus where cat=10

163 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

164 (304.22210693359): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

165 (!!!!! 1434.0877532959): insert into jos_banners_delta values (14615,'2025-08-19 15:49:48','216.73.216.0','view'),(14202,'2025-08-19 15:49:48','216.73.216.0','view'),(14203,'2025-08-19 15:49:48','216.73.216.0','view')

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