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Minimal Dose CT Identifies Lung Tumors Earlier

By MedImaging International staff writers
Posted on 29 May 2013

In a recent study, thoracic surgery and diagnostic radiologists demonstrated that minimal-dose computed tomography (MnDCT) imaging of the thorax provides much greater sensitivity at detecting new or recurrent lung cancer, with equivalent amount of radiation, compared to conventional chest X-rays.

Lung cancer is associated with very high mortality, partly because it is difficult to find at early stages, but also because it can recur frequently after surgical removal. The question arises as to what is the best way to follow lung cancer patients after surgery to target problems early enough, before symptoms become apparent, so that patients may still be eligible for new interventions.

The study’s findings were presented May 8, 2013, at the 93rd American Association for Thoracic Surgery (AATS) annual meeting, held in Minneapolis (MN, USA). “Up to a few years ago, we were using chest X-rays to monitor patients after surgery for lung cancer, but this follow-up was ineffective, and many patients still died of recurrent lung cancer, noted lead investigator Waël C. Hanna, MDCM, MBA, from the department of thoracic surgery at the University of Toronto (ON, Canada). “While CT scans can effectively be used to monitor lung cancer after surgery, there was significant concern about the large amount of radiation that will be delivered to patients, and standard dose CT scans were not used routinely in the follow-up of lung cancer. More recently, new technology allowed us to develop MnDCT.”

As reported in this study, most of new or recurrent cancer was identified by MnDCT at a subclinical, intrathoracic stage, within two years of surgery. This allowed for the delivery of curative treatment in the majority of patients with asymptomatic cancer and was associated with long survival.

The study tracked 271 patients with lung cancer (80% stage I, 12.5% stage II) who underwent curative resection of lung cancer. Repeated imaging occurred at 3, 6, 12, 18, 24, 36, 48, and 60 months using both conventional chest X-rays and MnDCT scans. Investigators revealed that MnDCT detected 94% of recurrent cancers compared to only 21% with standard X-rays (p < 0.0001). Significantly, the recurrent lung cancer was detected at a much earlier stage, allowing patients to feasibly undergo another curative surgery.

Identification of a new or recurrent tumor in asymptomatic patients led to additional surgery or radiation for 75.5%, while palliative treatment was recommended for the remainder of patients. Survival in the treated group was considerably longer than those who were treated with palliative intent (69 months vs. 15 months, p < 0.0001).

“MnDCT offers the best of both worlds: on the one hand it allows for precise imaging close to what is produced from a standard CT scan, and on the other hand it only delivers a small amount of radiation which is comparable to what a regular X-ray would deliver and much less than a standard dose CT scan,” said Dr. Hanna. “More importantly, now we can detect recurrent lung cancer at a much earlier stage, allowing patients to possibly undergo another surgery, and live longer, healthier lives.”

The study did find that MnDCT findings generated a high rate of false-positives, and the need for surgeons to be alert to this limitation in order to make correct clinical judgments regarding follow-up treatment.

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60 (280.85708618164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

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62 (!!!!! 1569.9863433838): SELECT fid FROM jos_deeppockets WHERE id=294746518 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746518 AND published='1' LIMIT 1

63 (!!!!! 6191.0152435303): 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 (!!!!! 7867.0978546143): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 7858.9916229248): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 8180.1414489746): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 7773.1609344482): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 7826.0898590088): SELECT fid FROM jos_deeppockets WHERE id=294746518 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746518 AND published='1' LIMIT 1

69 (!!!!! 7901.9069671631): 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 (!!!!! 4307.9853057861): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 7332.8018188477): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 7951.9748687744): 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 (906.94427490234): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (338.07754516602): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (735.99815368652): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (209.09309387207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 2355.8139801025): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (374.07875061035): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (241.99485778809): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (714.06364440918): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (257.96890258789): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 1174.9267578125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (44.107437133789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (242.94853210449): 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 (!!!!! 1068.115234375): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (442.9817199707): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (378.13186645508): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (!!!!! 3407.0014953613): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (63.180923461914): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (337.12387084961): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (211.00044250488): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (808.0005645752): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 6251.8119812012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

105 (349.04479980469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

106 (336.88545227051): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (907.89794921875): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1872.0626831055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

109 (231.98127746582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

110 (!!!!! 2298.11668396): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (833.98818969727): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1612.9016876221): 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 (!!!!! 1739.9787902832): 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 (765.80047607422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

115 (197.8874206543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

116 (!!!!! 1154.1843414307): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

117 (422.00088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

118 (!!!!! 1425.02784729): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

119 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

120 (273.9429473877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

121 (555.99212646484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

122 (!!!!! 1797.9145050049): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 145674.94392395): 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 (!!!!! 1746.1776733398): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746518 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746518 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1883.9836120605): ( 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 (!!!!! 4043.1022644043): ( 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 (391.00646972656): 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 (!!!!! 3470.1824188232): 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 (838.04130554199): 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 (!!!!! 2604.9613952637): 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 (302.07633972168): 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 (!!!!! 3910.0646972656): 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 (346.89903259277): 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 (108.95729064941): 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 (389.09912109375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (249.14741516113): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (36.954879760742): SELECT name FROM jos_deeppockets WHERE id=211

138 (26.941299438477): SELECT name FROM jos_deeppockets WHERE id=211

139 (521.89826965332): 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 (546.93222045898): 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 (545.02487182617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

142 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

143 (!!!!! 19803.047180176): TRUNCATE TABLE jos_trademed_module

144 (142.09747314453): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 1708.984375): 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=294746518 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (589.13230895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (153.0647277832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

149 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

150 (!!!!! 1540.8992767334): 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 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

152 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

153 (33.855438232422): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746518 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746518 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (29.087066650391): 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 (25.98762512207): 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 (28.848648071289): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

158 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746518 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746518 AND published='1' LIMIT 1

159 (89.168548583984): select jos_twitters.link from jos_twitters where cat=10

160 (42.915344238281): select jos_facebook.link from jos_facebook where cat=10

161 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

162 (37.193298339844): select jos_linkedin.link from jos_linkedin where cat=10

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