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Ultrasound Shear Wave Elastography Provides Painless Liver Biopsy

By MedImaging International staff writers
Posted on 10 Jan 2017

Image: An example of Shear Wave Elastography (SWE) images of the liver (Photo courtesy of MGH Department of Radiology).

While histopathology is still the overall standard for assessing and staging chronic liver fibrosis, researchers in the US have started using a new ultrasound technique called Shear Wave Elastography (SWE), and found that it is just as reliable, and can prevent the need for patient to undergo a painful biopsy.

Every year chronic liver diseases, especially cirrhosis of the liver and chronic liver fibrosis, are responsible for 1.2% of deaths in the US alone. Early detection and staging of fibrosis, and inflammation enable clinicians to determine prognoses and can help them predict the outcome of treatments. Liver fibrosis can even be reversed if detected early enough and treated on time.

The researchers from the Lahey Hospital and Medical Center (Burlington, MA, USA) used the SWE ultrasound technique to supplement, and often to replace liver biopsies in approximately 50 interventions per month. They presented their findings at annual Radiological Society of North America (RSNA 2016) meeting in Chicago, in the US. According to the researchers, most healthcare facilities could use the new SWE technology with their existing ultrasound equipment, after performing a software upgrade.

SWE is used to quantify tissue stiffness and to find diseased, and potentially malignant tissue. Liver tissue stiffness is measured in kilopascals (kPA), which is then converted to the METAVIR scale (F0 to F4) used for grading histopathology specimens. SWE is non-invasive and fast, and can be used to sample much larger areas than a biopsy.

According to the researchers, SWE will be useful for regular follow-up screening without exposing patients to ionizing radiation from Computed Tomography (CT) exams, performing costly Magnetic Resonance Imaging (MRI) scans, or painful invasive biopsies.

Pauley Chea, MD, radiology resident at Lahey Clinic, who presented the study, said, "Switching over can happen fairly quickly — it's just a matter of deciding whether it's what a facility needs. The beauty is that it's simple to read. Essentially, you place the probe in a particular position and press a button."

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62 (838.9949798584): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

63 (!!!!! 4065.990447998): 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

64 (620.12672424316): SELECT fid FROM jos_deeppockets WHERE id=294767622 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294767622 AND published='1' LIMIT 1

65 (!!!!! 6902.9331207275): 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`

66 (194.07272338867): select jos_twitters.link from jos_twitters where cat=10

67 (56.982040405273): select jos_facebook.link from jos_facebook where cat=10

68 (43.869018554688): select jos_google_plus.link from jos_google_plus where cat=10

69 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

70 (53.882598876953): SELECT fid FROM jos_deeppockets WHERE id=294767622 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294767622 AND published='1' LIMIT 1

71 (45.061111450195): 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`

72 (269.88983154297): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (196.21849060059): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (368.11828613281): 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`

75 (!!!!! 3369.8081970215): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (303.03001403809): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (658.98895263672): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (264.16778564453): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (244.140625): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (177.86026000977): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (301.12266540527): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (180.00602722168): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (784.15870666504): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (305.8910369873): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (823.02093505859): 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`

92 (!!!!! 1124.1436004639): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (333.07075500488): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (216.96090698242): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (!!!!! 2977.8480529785): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (358.10470581055): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (163.07830810547): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (137.0906829834): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

107 (540.01808166504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

108 (!!!!! 2048.9692687988): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (191.92695617676): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (232.93495178223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

111 (458.95576477051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

112 (685.9302520752): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (772.95303344727): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (586.03286743164): 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 (437.97492980957): 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 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

117 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

118 (124.21607971191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

119 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

120 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

121 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

122 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

123 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

124 (342.84591674805): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 177230.1197052): 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

126 (!!!!! 6294.9657440186): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767622 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767622 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 4269.8383331299): ( 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 (!!!!! 3878.116607666): ( 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 (!!!!! 2434.0152740479): 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 (437.97492980957): 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 (597.00012207031): 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 (250.10108947754): 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 (622.03407287598): 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 (304.9373626709): 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 (224.11346435547): 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 (!!!!! 2604.0077209473): 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 (521.89826965332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (385.04600524902): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (185.01281738281): SELECT name FROM jos_deeppockets WHERE id=214

140 (61.988830566406): SELECT name FROM jos_deeppockets WHERE id=214

141 (745.77331542969): 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 (!!!!! 1925.9452819824): 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 (!!!!! 1998.1861114502): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

144 (145.91217041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

145 (!!!!! 19897.937774658): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 2368.9270019531): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 2100.944519043): 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=294767622 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (433.92181396484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

151 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

152 (!!!!! 2364.8738861084): 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

153 (!!!!! 1497.9839324951): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

154 (!!!!! 2217.0543670654): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

155 (!!!!! 6469.9649810791): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767622 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767622 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (!!!!! 5258.0833435059): 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 (!!!!! 7933.1398010254): 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 (!!!!! 4698.9917755127): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (!!!!! 5986.213684082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

160 (!!!!! 8627.8915405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767622 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767622 AND published='1' LIMIT 1

161 (45.7763671875): select jos_twitters.link from jos_twitters where cat=10

162 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

163 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

164 (288.00964355469): select jos_linkedin.link from jos_linkedin where cat=10

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