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Ultrasound Provides a Faster, More Effective Ovarian Cancer Diagnosis

By MedImaging International staff writers
Posted on 12 Jan 2011

It is crucial to differentiate between benign and malignant ovarian cysts and tumors in a fast and reliable way, thus improving the surgical management and prognosis of the patient. A Belgian scientist has proven in a recent study that ultrasound-based simple rules may effectively differentiate between malignant and benign tumors.

The research was led by Prof. Dirk Timmerman, clinical head of gynecology at the University Hospitals Gasthuisberg Campus (Belgium). Ovarian cancer a malignant tumor in the ovaries is the most lethal female malignancy because in many instances, the disease has few symptoms. Consequently, it is frequently only diagnosed once it has reached a very advanced stage. Treatment of ovarian cancer consists of laparotomy, possibly preceded by a course of chemotherapy. A laparotomy is an invasive open operation that involves making a large incision and removing all the tumor tissue. Most cysts in the ovaries are benign, however, and they may spontaneously disappear. In instances where an operation does prove necessary, laparoscopy or keyhole surgery offers many advantages. This involves removing only the cyst itself, via very small incisions.

The ultrasound examination imaging with ultrasound sound waves is crucial, Prof. Timmerman explained, "It is not always easy to characterize ovarian tumors, but a reliable preoperative diagnosis is very important. When operating on a malignant tumor, the cystic contents should not be spilled, because spread of the cancer cells in the abdomen clearly decreases the patient's chances of survival. Conversely, when it comes to benign tumors, especially in younger women who wish to bear children it is important to avoid unnecessary operations that may reduce their fertility and may result in a large abdominal scar and a longer stay in hospital.”

Prof. Timmerman is the coordinator of the International Ovarian Tumor Analysis Group (IOTA), an international cooperation between ultrasound centers in various countries with medical doctors and an interdisciplinary team of engineers and biostatisticians at the department of electrical engineering, ESAT-SCD, Katholieke Universiteit Leuven (Belgium). Together with Dr. Lieveke Ameye and Prof. Sabine Van Huffel of ESAT-SCD, Prof. Timmerman has developed a set of rules to distinguish between benign and malignant tumors with ultrasound examination. "We needed a simple and reliable triage method,” Prof. Timmerman explained. "Existing tests were either expensive and time-consuming, or unreliable. There are mathematical models you can use to distinguish between different types of tumors, but computers are not always available during the ultrasound examination, especially not in developing countries. Moreover, in many places, ultrasound examination of the ovaries is not performed by specialized medical doctors or very experienced examiners.”

The simple ultrasound rules include external characteristics of the tumor: the irregular and solid form, diameter, papillations, internal cyst walls, blood flow, and calcifications. If a cyst has one of the five features of a benign tumor or one of the five features of a malignant tumor, it is classified in one of the two respective categories. The procedure has been tested on nearly 2,000 women who subsequently underwent surgery. In 77% of the cases, the rules proved applicable and research of the removed tumor demonstrated that the rules were very reliable for predicting whether the tumors were benign or malignant. In other cases if there are none of these features or if both benign and malignant features are present an examination by an experienced ultrasound examiner is the best method.

Hundreds of thousands of cases of ovarian cancer are diagnosed yearly worldwide. As the symptoms of ovarian cancer are not specific, it is important, according to the researchers, to plan a thorough examination if there are any symptoms, such as abdominal swelling, loss of appetite, pain, or abnormal bleeding.

Related Links:
University Hospitals Gasthuisberg
Katholieke Universiteit Leuven

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58 (273.9429473877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

59 (!!!!! 1951.9329071045): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

60 (473.97613525391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

61 (!!!!! 3862.8578186035): 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 (!!!!! 1193.0465698242): SELECT fid FROM jos_deeppockets WHERE id=294732910 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732910 AND published='1' LIMIT 1

63 (149.01161193848): 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`

64 (!!!!! 2807.8556060791): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 5012.9890441895): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 2146.0056304932): select jos_google_plus.link from jos_google_plus where cat=10

67 (762.939453125): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 2209.1865539551): SELECT fid FROM jos_deeppockets WHERE id=294732910 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294732910 AND published='1' LIMIT 1

69 (!!!!! 1796.9608306885): 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`

70 (652.07481384277): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (446.08116149902): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1145.1244354248): 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 (!!!!! 1064.0621185303): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (836.13395690918): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (313.04359436035): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (847.10121154785): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (285.86387634277): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (337.12387084961): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (130.89179992676): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (762.939453125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (51.975250244141): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (52.928924560547): 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 (89.883804321289): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2562.0460510254): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

105 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

106 (613.92784118652): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1461.0290527344): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 2751.1119842529): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

109 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

110 (!!!!! 1876.1157989502): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 8861.0649108887): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (677.82402038574): 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 (332.11708068848): 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 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

115 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

116 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

117 (50.783157348633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

118 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

119 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

120 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

121 (47.206878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

122 (293.97010803223): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 180981.87446594): 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 (660.89630126953): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732910 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732910 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 54439.067840576): ( 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 (!!!!! 1381.8740844727): ( 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 (123.02398681641): 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 (159.97886657715): 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 (228.8818359375): 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 (103.95050048828): 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 (208.85467529297): 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 (!!!!! 1271.0094451904): 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 (!!!!! 1382.1125030518): 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 (!!!!! 3789.1864776611): 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 (509.97734069824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (496.14906311035): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (71.048736572266): SELECT name FROM jos_deeppockets WHERE id=214

138 (36.954879760742): SELECT name FROM jos_deeppockets WHERE id=214

139 (771.99935913086): 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

140 (!!!!! 1244.068145752): 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 (!!!!! 1562.1185302734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

142 (849.00856018066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

143 (!!!!! 14281.988143921): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 3015.9950256348): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (102.04315185547): 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=294732910 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (545.97854614258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

149 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

150 (!!!!! 1497.0302581787): 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 (137.8059387207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

152 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

153 (47.922134399414): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294732910 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294732910 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (37.908554077148): 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)

155 (34.093856811523): 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 (41.007995605469): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

158 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294732910 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294732910 AND published='1' LIMIT 1

159 (61.988830566406): select jos_twitters.link from jos_twitters where cat=10

160 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

161 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

162 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

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