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Transperineal 3D Mapping Biopsy for Prostate Cancer Diagnosis Decreases Need for Prostatectomy

By MedImaging International staff writers
Posted on 04 Aug 2011

The diagnosis and treatment of prostate cancer (PCa) is currently undergoing a revolution similar to that seen over the past three decades with respect to the improvements made in breast cancer screening, diagnosis and treatment options. The long-standing gold standard for PCa diagnosis is the transrectal ultrasound (TRUS)-guided prostate needle biopsy. Whereas TRUS is still used to make an initial diagnosis, in recent years, the development of a staging prostate biopsy--the transperineal three-dimensional (3D) mapping biopsy--has been introduced, allowing physicians to understand better the stage and gravity of the cancer in order to make more informed treatment decisions.

“We have been working hard to bring prostate cancer diagnosis and treatment to more advanced states. Our approach follows similar efforts from breast cancer patients and advocates, which have led to the decline of radical mastectomies, an increase in research and better diagnostic test, treatment, and surgical options,” said Dr. E. David Crawford, chairman, Prostate Conditions Education Council (Centennial, CO, USA) and professor of urology and radiation oncology, University of Colorado (Boulder, USA).

Experts agree that prostate staging biopsies will yield better understanding of the extent and aggressiveness of the disease in patients. This information allows physicians to develop customized treatment plans for patients. “We expect to see a decline in the number of men who are undergoing unnecessary prostatectomies or radiotherapy,” said Dr. Crawford. “This, coupled with new focalized treatments that are the equivalent of the ‘male lumpectomy’ should help us see an increase in positive outcomes for men diagnosed with the disease.”

The TRUS needle biopsy is an outpatient surgical procedure in which a transrectal ultrasound is used to create an image of the prostate, allowing a physician to guide a small needle to take 6-12 samples of prostate tissue to test for abnormal cells and tissue. For many years, it has been the definitive way to diagnose prostate cancer. But under- and overgrading of the cancer is common, which can lead to patients undergoing treatments that are unnecessarily invasive or being subjected to the risk of associated morbidities from other treatment methods.

The prostate staging biopsies (PSB) procedure is performed as an outpatient procedure under general anesthesia. It allows physicians to create a 3D image of the prostate, including the location of the cancer within the organ. Because PSB can better determine the size and location of the cancer, it allows patients and their physicians to select a more appropriate treatment option, including ongoing evaluation.

In a recent study, 215 men underwent PSB. Of those, only 38 chose to have radical prostatectomy, while the majority of the remaining men underwent targeted therapy and 44 elected to watch and wait. No studies have reported a significant difference in the risks or complications between the two procedures.

Prostate cancer is the number two cause of cancer deaths in American men. According to the US National Cancer Institute (Bethesda, MD, USA), there were an estimated 217,730 new diagnoses and 32,050 deaths from prostate cancer in the United States in 2010. One in six men over age 40 will develop prostate cancer. It is typically diagnosed in men over the age 65, and African-American men are in the highest risk group.

According to the US National Institutes of Health (Bethesda, MD, USA), the US expenditure for prostate cancer care was expected to be US$12 billion, making it the fifth most expensive type of cancer behind breast ($16.5 billion), colorectal ($14.14 billion), lymphoma ($12.14 billion), and lung ($12.12 billion) cancers.

An organization committed to men’s health, the Prostate Conditions Education Council (PCEC)--formally the Prostate Cancer Education Council--is a US-leading resource for information on prostate health. The Council, which comprises a consortium of leading physicians, health educators, scientists, and prostate cancer advocates, aims to conduct nationwide screenings for men and perform research that will aid in the detection and treatment of prostate conditions.

Related Links:
Prostate Conditions Education Council
University of Colorado
National Cancer Institute - Prostate Cancer Page

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57 (42.915344238281): SELECT a.* FROM jos_components AS a WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' ) AND a.option = 'com_syndicate'

58 (74.863433837891): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

59 (470.16143798828): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

60 (!!!!! 1598.8349914551): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

61 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

62 (168.0850982666): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

63 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

64 (132.08389282227): 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

65 (635.86235046387): SELECT fid FROM jos_deeppockets WHERE id=294736451 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736451 AND published='1' LIMIT 1

66 (48.87580871582): 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`

67 (37.908554077148): select jos_twitters.link from jos_twitters where cat=10

68 (39.815902709961): select jos_facebook.link from jos_facebook where cat=10

69 (42.915344238281): select jos_google_plus.link from jos_google_plus where cat=10

70 (40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10

71 (64.13459777832): SELECT fid FROM jos_deeppockets WHERE id=294736451 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736451 AND published='1' LIMIT 1

72 (49.114227294922): 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`

73 (424.14665222168): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (302.07633972168): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (48.160552978516): 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`

76 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (90.122222900391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (64.13459777832): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (46.014785766602): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (46.968460083008): 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`

93 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

108 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

109 (54.836273193359): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (69.856643676758): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (125.88500976562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

112 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

113 (75.101852416992): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (670.19462585449): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (667.09518432617): 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

116 (442.0280456543): 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

117 (104.18891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

118 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

119 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

120 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

121 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

122 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

123 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

124 (62.227249145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

125 (394.10591125488): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 21920.919418335): 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

127 (648.02169799805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736451 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736451 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 8545.8755493164): ( 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

129 (141.14379882812): ( 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

130 (72.002410888672): 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

131 (41.961669921875): 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

132 (66.995620727539): 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

133 (34.809112548828): 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

134 (458.0020904541): 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

135 (57.93571472168): 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

136 (49.829483032227): 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

137 (39.815902709961): 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

138 (645.87593078613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (524.99771118164): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (57.93571472168): SELECT name FROM jos_deeppockets WHERE id=214

141 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=214

142 (774.14512634277): 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

143 (774.86038208008): 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

144 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

145 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

146 (!!!!! 10813.95149231): TRUNCATE TABLE jos_trademed_module

147 (140.90538024902): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (100.85105895996): 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=294736451 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (!!!!! 5000.114440918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (100.13580322266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

152 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

153 (!!!!! 2366.0659790039): 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

154 (154.01840209961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

155 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

156 (56.028366088867): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736451 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736451 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (45.061111450195): 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)

158 (40.054321289062): 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)

159 (52.928924560547): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (91.791152954102): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

161 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736451 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736451 AND published='1' LIMIT 1

162 (53.167343139648): select jos_twitters.link from jos_twitters where cat=10

163 (83.92333984375): select jos_facebook.link from jos_facebook where cat=10

164 (59.127807617188): select jos_google_plus.link from jos_google_plus where cat=10

165 (40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10

166 (319.00405883789): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

167 (!!!!! 1960.9928131104): insert into jos_banners_delta values (14202,'2025-08-12 18:33:34','216.73.216.186','view'),(14203,'2025-08-12 18:33:34','216.73.216.186','view')

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