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Repeat Nuclear and CT Imaging Increases Breast Cancer Risk

By MedImaging International staff writers
Posted on 19 Dec 2012

Researchers reviewing the records of approximately 250,000 women enrolled in an integrated healthcare delivery system revealed that increased computed tomography (CT) scanning utilization between 2000 and 2010 could result in a rise in the risk of breast cancer for specific women, including younger patients and those who received repeat scans. According to the study, nuclear medicine imaging may also be a factor for increased breast cancer risk.

The study’s findings were presented in November 2012 at the annual meeting of the Radiological Society of North America (RSNA), held in Chicago (IL, USA). CT uses ionizing radiation in the form of X-rays to generate cross-sectional images of the body. In nuclear medicine imaging, a radiopharmaceutical--a compound that includes a small amount of a radioactive material--is delivered inside the body to help visualize internal organs.

“When a woman undergoes CT or nuclear medicine imaging of her chest, abdomen or spine, her breast tissue will absorb some radiation,” said senior author Rebecca Smith-Bindman, MD, professor of radiology and biomedical imaging at the University of California, San Francisco (USA). “Breast tissue is one of the tissues in the body known to be sensitive to developing cancer as a result of radiation exposure.”

The study, led by Ginger Merry, MD, MPH, breast imaging fellow at Prentice Women’s Hospital-Northwestern Memorial Hospital ( Chicago, IL, USA) found that among the system’s female enrollees, CT utilization increased from 99.8 CT scans per 1,000 women in 2000 to 192.4 CT scans per 1,000 women in 2010 (a yearly increase of 6.8%). In 2010, 46% of those CT scans exposed the breast to radiation. Nuclear medicine imaging decreased from 39.3 scans per 1,000 women in 2000 to 27.5 scans per 1,000 women in 2010 (a 3.5% yearly decline); however, in 2010, 84% of nuclear medicine studies exposed the breast to radiation.

“Until now, the impact of this increased use of imaging on radiation exposure to breast tissue and the subsequent risk of breast cancer has not been known,” Dr. Smith-Bindman said. “Our goal was to quantify imaging utilization and radiation exposure to the breast among women enrolled in an integrated healthcare delivery system and to use these data to determine the imaging-related risk of breast cancer from those studies.”

The investigators gathered CT dose data from 1,656 patients who underwent CT scanning that exposed the breast to radiation, and employing a new automated computational strategy, estimated the patients’ effective radiation dose and the amount of radiation absorbed by the breast. The researchers also analyzed the radiopharmaceutical volume and associated radiation exposure used in 5,507 nuclear medicine exams that exposed the breast to radiation.

“We found that the estimated breast radiation doses from CT were highly variable across patients, with the highest doses coming from multiple-phase cardiac and chest CT examinations, where successive images of the organ being studied are captured,” Dr. Smith-Bindman said.

The researchers then estimated the women’s imaging-related risk of breast cancer and compared it to their underlying risk of developing breast cancer. Each woman’s 10-year imaging-related risk of developing breast cancer, starting 10 years after her exposure to imaging and based on her age at exposure, was estimated using the breast-specific radiation data and a statistical risk model. A women’s underlying risk of developing breast cancer was estimated based on data collected by the US National Cancer Institute-funded Breast Cancer Surveillance Consortium.

“Young women receiving several chest and or cardiac CTs had the greatest increased risk of developing breast cancer at approximately 20%,” said Diana Miglioretti, PhD, study coauthor and senior investigator at the Group Health Research Institute (Seattle, WA, USA). “A 15-year-old girl with no risk factors for breast cancer would double her 10-year risk of developing breast cancer at 25.”

Dr. Smith-Bindman noted that, to lower the imaging-related risk of developing breast cancer, imaging providers should assess the radiation doses associated with each exam, reduce the use of multiphase protocols, and employ dose-reduction software wherever possible to lessen exposures.

“If imaging is truly indicated, then the risk of developing cancer is small and should not dissuade women from getting the test they need,” Dr. Smith-Bindman said. “On the other hand, a lot of patients are undergoing repeat chest and cardiac CT, many of which aren’t necessary. Women, and particularly young women, should understand there is a small but real potential risk of breast cancer associated with cardiac and chest CT, and the risk increases with the number of scans.”

Related Links:
University of California, San Francisco
Group Health Research Institute
Prentice Women’s Hospital-Northwestern Memorial Hospital

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57 (!!!!! 1630.0678253174): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

58 (329.01763916016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

59 (!!!!! 6665.2297973633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

60 (!!!!! 8365.8695220947): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

61 (!!!!! 1195.9075927734): 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 (715.97099304199): SELECT fid FROM jos_deeppockets WHERE id=294743892 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294743892 AND published='1' LIMIT 1

63 (!!!!! 2883.9111328125): 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 (!!!!! 1655.8170318604): select jos_twitters.link from jos_twitters where cat=10

65 (479.93659973145): select jos_facebook.link from jos_facebook where cat=10

66 (940.08445739746): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 1911.1633300781): select jos_linkedin.link from jos_linkedin where cat=10

68 (515.93780517578): SELECT fid FROM jos_deeppockets WHERE id=294743892 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294743892 AND published='1' LIMIT 1

69 (304.9373626709): 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 (!!!!! 3221.9886779785): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (554.08477783203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (439.88227844238): 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 (729.08401489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (639.20021057129): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (222.92137145996): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (201.22528076172): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (258.9225769043): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (609.8747253418): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (257.01522827148): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 2518.892288208): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (437.02125549316): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (445.84274291992): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (597.00012207031): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (!!!!! 1296.9970703125): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (879.04930114746): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (!!!!! 1055.9558868408): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 3924.8466491699): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (578.16505432129): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (373.84033203125): 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 (!!!!! 2259.0160369873): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (361.20414733887): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (714.06364440918): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (370.97930908203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (450.84953308105): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (978.94668579102): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (509.97734069824): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (217.91458129883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (511.88468933105): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (193.83430480957): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (306.84471130371): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2922.0581054688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

105 (971.07887268066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

106 (925.06408691406): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 2266.8838500977): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 6335.0200653076): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

109 (584.12551879883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

110 (913.14315795898): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (737.90550231934): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (653.02848815918): 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 (440.83595275879): 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=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

115 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

116 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

117 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

118 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

119 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

120 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

121 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

122 (281.09550476074): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 107897.04322815): 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 (!!!!! 7482.0518493652): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743892 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743892 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 3667.8314208984): ( 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 (!!!!! 3004.789352417): ( 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 (349.99847412109): 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 (406.98051452637): 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 (204.08630371094): 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 (134.94491577148): 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 (138.99803161621): 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 (119.92454528809): 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 (148.05793762207): 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 (30.040740966797): 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 (!!!!! 1307.9643249512): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 1181.8408966064): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (735.04447937012): SELECT name FROM jos_deeppockets WHERE id=211

138 (186.20491027832): SELECT name FROM jos_deeppockets WHERE id=211

139 (979.90036010742): 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 (991.1060333252): 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 (!!!!! 2872.9438781738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

142 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

143 (!!!!! 12465.000152588): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1246.9291687012): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 1384.973526001): 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=294743892 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 5300.9986877441): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (268.93615722656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1277.2083282471): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

149 (250.81634521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

150 (!!!!! 3978.0139923096): 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 (!!!!! 1255.989074707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

152 (761.98577880859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

153 (139.95170593262): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294743892 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294743892 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (252.00843811035): 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 (46.968460083008): 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 (!!!!! 1580.9535980225): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 3436.0885620117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

158 (!!!!! 1199.9607086182): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294743892 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294743892 AND published='1' LIMIT 1

159 (66.041946411133): select jos_twitters.link from jos_twitters where cat=10

160 (39.100646972656): select jos_facebook.link from jos_facebook where cat=10

161 (38.14697265625): select jos_google_plus.link from jos_google_plus where cat=10

162 (523.09036254883): select jos_linkedin.link from jos_linkedin where cat=10

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