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PET-CT Identifies Ruptured and High-Risk Coronary Plaque

By MedImaging International staff writers
Posted on 09 Jan 2014

Image: The Biograph mCT PET-CT system by Siemens Healthcare (Photo courtesy of Siemens Healthcare).

Scientists have discovered that the tracer ¹⁸F-sodium fluoride (¹⁸F-NaF) used with positron emission tomography-computed tomography (PET-CT) imaging technology is the first noninvasive imaging modality to identify and localize ruptured and high-risk coronary plaque.

The University of Edinburgh (Scotland, UK) is leading the heart disease study with the help of a Biograph mCT PET-CT system developed by Siemens Healthcare (Erlangen, Germany). The new study’s findings were published October 2013 in the Lancet. Currently there is no noninvasive way of finding high-risk plaques at risk of rupturing and causing a heart attack. The imaging technology is providing new clues into clinical research into early diagnosis of the disorder.

In the prospective clinical trial, patients with myocardial infarction and stable angina underwent ¹⁸F-NaF and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET-CT and invasive coronary angiography. ¹⁸F-NaF uptake was compared with histology in carotid endarterectomy specimens from patients with symptomatic carotid disease, and with intravascular ultrasound in patients with stable angina. The primary endpoint was the comparison of ¹⁸F-fluoride tissue-to-background ratios of culprit and non-culprit coronary plaques of patients with acute myocardial infarction.

In 93% (37) of patients with myocardial infarction, the highest coronary ¹⁸F-NaF uptake was seen in the culprit plaque. By contrast, coronary ¹⁸F-fluorodeoxyglucose (FDG) uptake was typically concealed by myocardial uptake and where discernible, there were no differences between culprit and non-culprit plaques. Marked ¹⁸F-NaF uptake occurred at the site of all carotid plaque ruptures and was linked with histologic evidence of active calcification, macrophage infiltration, apoptosis, and necrosis. Forty-five percent (18) of patients with stable angina had plaques with focal ¹⁸F-NaF uptake that were associated with more high-risk features on intravascular ultrasound than those without uptake.

The plaque areas in the blood vessels were easily identifiable by using the Biograph mCT scanner. In the patients with angina, advanced notice that they had high-risk plaques and a heart attack may be impending. These patients could then be targeted with aggressive therapy to avoid future events.

“Being able to identify dangerous fatty plaques likely to cause a heart attack is something that conventional heart tests can’t do. This research suggests that PET-CT scanning may provide an answer, identifying ‘ticking time bomb’ patients at risk of a heart attack,” said Prof. Peter Weissberg, medical director at the British Heart Foundation (BHF; London, UK). “Nearly 20 years of BHF-funded research has led us to this point. We now need to confirm these findings, and then understand how best to use new tests like this in the clinic to benefit heart patients.”

BHF clinical lecturer and cardiologist Dr. Marc Dweck, who led the research at the University of Edinburgh, stated: “We have developed what we hope is a way to ‘light up’ plaques on the brink of rupturing and causing a heart attack. If we could know how close a person is to having a heart attack, we could step in with medication or surgery before the damage is done. This is a first step towards that goal. The next stage is to confirm these findings in larger studies to establish first that this technique can truly predict heart attacks and secondly that treatment can help patients avoid these events.”

“Siemens Healthcare is delighted that the Biograph mCT is aiding ground-breaking research into the UK’s biggest killer—heart disease,” remarked Lawrence Foulsham, business manager, molecular imaging at Siemens Healthcare. “The condition is a clinical priority for the UK; therefore advancements in this field are incredibly important. We have a long-standing partnership with the Clinical Research Imaging Center at the University of Edinburgh and look forward to assisting them with further clinical research insights into the future.”

The Clinical Research Imaging Center at the University of Edinburgh installed the Biograph mCT in 2010.

Related Links:
Siemens Healthcare
University of Edinburgh

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61 (!!!!! 2479.076385498): 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 (427.9613494873): SELECT fid FROM jos_deeppockets WHERE id=294750062 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294750062 AND published='1' LIMIT 1

63 (266.79039001465): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

64 (72.956085205078): select jos_twitters.link from jos_twitters where cat=10

65 (93.936920166016): select jos_facebook.link from jos_facebook where cat=10

66 (66.995620727539): select jos_google_plus.link from jos_google_plus where cat=10

67 (47.922134399414): select jos_linkedin.link from jos_linkedin where cat=10

68 (577.92663574219): SELECT fid FROM jos_deeppockets WHERE id=294750062 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294750062 AND published='1' LIMIT 1

69 (100.85105895996): 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 (321.1498260498): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (270.12825012207): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (51.021575927734): 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 (77.009201049805): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.014785766602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (37.193298339844): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): 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 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (380.9928894043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

105 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

106 (145.91217041016): 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=294750062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (128.98445129395): 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=294750062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1071.9299316406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

109 (116.10984802246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

110 (126.83868408203): 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=294750062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (664.94941711426): 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=294750062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (727.89192199707): 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 (422.95455932617): 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 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

116 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

117 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

118 (110.14938354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

119 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

120 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

121 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

122 (479.93659973145): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750062 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750062 AND type='deeppockets_item' AND published='1' LIMIT 1

123 (!!!!! 941370.01037598): ( 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

124 (96.797943115234): ( 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

125 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

126 (37.193298339844): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

127 (55.074691772461): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

128 (38.14697265625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

129 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

130 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

131 (503.0632019043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

132 (397.2053527832): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

133 (196.93374633789): SELECT name FROM jos_deeppockets WHERE id=211

134 (32.186508178711): SELECT name FROM jos_deeppockets WHERE id=211

135 (524.04403686523): 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

136 (497.10273742676): 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

137 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

138 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

139 (283.00285339355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

142 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

143 (!!!!! 1033.0677032471): 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

144 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

145 (52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

146 (43.153762817383): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294750062 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294750062 AND type='deeppockets_item' AND published='1' LIMIT 1

147 (32.186508178711): 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)

148 (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)

149 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

150 (145.91217041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

151 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294750062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294750062 AND published='1' LIMIT 1

152 (37.193298339844): select jos_twitters.link from jos_twitters where cat=10

153 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

154 (37.193298339844): select jos_google_plus.link from jos_google_plus where cat=10

155 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

156 (472.06878662109): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

157 (!!!!! 1210.9279632568): insert into jos_banners_delta values (14615,'2025-06-19 13:21:27','216.73.216.120','view'),(14202,'2025-06-19 13:21:27','216.73.216.120','view'),(14203,'2025-06-19 13:21:27','216.73.216.120','view')

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