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Automating Handheld Ultrasound Applications for Improved Diagnostic Accuracy and Reduced User Dependency

By MedImaging International staff writers
Posted on 06 May 2009

New handled ultrasound technology has been developed as a platform for workflow automation in image fusion, breast volume scanning, and application procedures and protocols.

Siemens Healthcare (Erlangen, Germany) demonstrated the benefits of workflow automation on the new release of its premier general imaging platform, the Acuson S2000 ultrasound system, at the annual conference of the American Institute of Ultrasound in Medicine (AIUM), April 2-5, 2009, in New York (NY, USA). More...

These systems comprise a variety of exam procedures and protocols that address the challenges that handheld ultrasound faces in regards to user-dependence and variability, as well as scan-related injuries. Siemens also highlighted how automation can support the viability of fusing ultrasound and computed tomography imaging in the clinical routine.

Offering the best of both worlds, computed tomography (CT) and ultrasound fusion combines the benefits of real-time ultrasound imaging with global imaging display of CT. However, current fusion techniques require bulky transmit and receive equipment to track the patient's anatomy in real time. Moreover, patients need to lie completely still during the entire exam to prevent elaborate manual realignments before the examination can continue.

"This is unrealistic and impractical. And it usually requires several attempts to get the job done, which makes the procedure time-consuming and the results inaccurate," said Klaus Hambüchen, chief executive officer, ultrasound, Siemens Healthcare. "Our fusion solution [which is a works-in progress] incorporates miniaturized, flexible sensors, and proprietary technology that automatically aligns the CT image to the current ultrasound view. This approach will dramatically accelerate workflow and improves the accuracy of image alignment, allowing fusion imaging to be seamlessly integrated into a routine ultrasound exam."

The limitations of handheld ultrasound in terms of scan time and user-variability have limited ultrasound's role in imaging to that of a secondary modality to look at a palpable mass or a finding identified on a mammogram. The Acuson S2000 automated breast volume scanner (ABVS) has the potential to change that. In less than 15 minutes, the system acquires full-field sonographic volumes of the breast. These volumes offer new insight into the intricate anatomy and architecture of the breast, including the intuitive anatomical coronal view, which has not been available using conventional hand held ultrasound.

After acquisition, the volume data are sent to a workstation for comprehensive offline review and diagnosis, as well as semi-automated reporting and BI-RADS reporting. A complete ultrasound breast imaging solution, the Acuson S2000 ABVS system also supports handheld ultrasound for innovative breast imaging applications, such as fatty tissue imaging, eSie Touch elasticity imaging, and biopsy procedures.

Siemens also presented their proprietary eSieScan workflow protocols on the Acuson S2000 system. Allowing the user to focus on patient care, not system interaction, eSieScan workflow protocols automatically guide the operator through the exam process by anticipating and executing exams based on customizable programs. Major modes, such as 2D, color, PW Doppler, or M-mode can be automatically activated along with a variety of submodes, such as eSie Touch elasticity or Cadence contrast pulse sequencing technology for contrast studies. (Currently, the U.S. Food and Drug Administration has cleared ultrasound contrast agents only for use in left ventricular opacification [LVO]).

ESieScan protocols are available for vascular, breast, and obstetric exams, but an unlimited number of user-defined protocols can be added to the system. By reducing the interaction of the user with the system, eSieScan protocols may lead to the reduction of repetitive stress injuries while at the same time increase the consistency and predictability of the exam content for the physician.

In combination with syngo Auto obstetric OB (obstetric) measurements, eSieScan workflow protocols help save up to 75% of the keystrokes required in routine fetal exams.

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57 (593.18542480469): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

58 (!!!!! 1780.0331115723): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

59 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

60 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

61 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

62 (339.98489379883): 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 (766.03889465332): SELECT fid FROM jos_deeppockets WHERE id=294723097 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294723097 AND published='1' LIMIT 1

64 (85.115432739258): 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=214 ORDER BY `ordering`

65 (98.943710327148): select jos_twitters.link from jos_twitters where cat=10

66 (56.028366088867): select jos_facebook.link from jos_facebook where cat=10

67 (50.067901611328): select jos_google_plus.link from jos_google_plus where cat=10

68 (77.962875366211): select jos_linkedin.link from jos_linkedin where cat=10

69 (130.89179992676): SELECT fid FROM jos_deeppockets WHERE id=294723097 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294723097 AND published='1' LIMIT 1

70 (61.988830566406): 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=214 ORDER BY `ordering`

71 (440.12069702148): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (393.86749267578): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (44.107437133789): 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 (94.890594482422): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (98.943710327148): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (60.081481933594): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (56.982040405273): 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 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (121.11663818359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

106 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

107 (91.791152954102): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (66.995620727539): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

110 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

111 (76.055526733398): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (779.86717224121): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (721.93145751953): 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 (579.1187286377): 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 (146.15058898926): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

116 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

117 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

118 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

119 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

120 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

121 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

122 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

123 (349.04479980469): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

124 (!!!!! 27510.88142395): 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 (666.85676574707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723097 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723097 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (!!!!! 8836.030960083): ( 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 (88.930130004883): ( 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 (40.054321289062): 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 (30.994415283203): 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 (41.007995605469): 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 (31.232833862305): 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 (452.99530029297): 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 (61.988830566406): 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 (40.054321289062): 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 (30.994415283203): 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 (530.95817565918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (442.9817199707): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (67.949295043945): SELECT name FROM jos_deeppockets WHERE id=214

139 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=214

140 (827.07405090332): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (697.85118103027): 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 '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

143 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

144 (!!!!! 8635.0440979004): TRUNCATE TABLE jos_trademed_module

145 (190.01960754395): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (138.99803161621): 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=294723097 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 1080.9898376465): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1345.8728790283): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

150 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

151 (!!!!! 1439.094543457): 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 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

153 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

154 (51.021575927734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723097 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723097 AND type='deeppockets_item' AND published='1' LIMIT 1

155 (41.007995605469): 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=214 or channel_id is null)

156 (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=214 or channel_id is null)

157 (76.055526733398): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

158 (329.97131347656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

159 (313.04359436035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723097 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723097 AND published='1' LIMIT 1

160 (164.98565673828): select jos_twitters.link from jos_twitters where cat=10

161 (722.16987609863): select jos_facebook.link from jos_facebook where cat=10

162 (312.08992004395): select jos_google_plus.link from jos_google_plus where cat=10

163 (402.92739868164): select jos_linkedin.link from jos_linkedin where cat=10

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