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MR-Guided Focused Ultrasound Controls Prostate Cancer with Fewer Side Effects

By MedImaging International staff writers
Posted on 16 Jun 2022

When the cancer is confined to the prostate gland, the main treatment options have traditionally included active surveillance (close monitoring), surgery, and radiation. More...

But men who needed surgery or radiation often had persistent side effects, such as urinary and sexual problems, that could reduce quality of life. In recent years, a new treatment strategy known as focal therapy (partial gland ablation) has emerged for prostate cancer considered to be “intermediate risk” - mostly, small tumors confined to one area of the prostate. Now, a landmark clinical trial has demonstrated that an advanced focal therapy approach and less-invasive method known as high-intensity focused ultrasound (HIFU), guided by magnetic resonance imaging (MRI), works well for many patients.

Results from the clinical trial conducted by researchers at Memorial Sloan Kettering Cancer Center (MSK, New York, NY, USA) represent a major step toward having the new HIFU approach become part of widespread prostate cancer treatment. The phase 2 trial looked at a particular type of HIFU treatment, also called MR-guided focused ultrasound (MRgFUS), in men with intermediate-risk cancer. The novel approach effectively controlled the disease in patients and greatly reduced adverse side effects of treatment. This suggests many men with intermediate-risk prostate cancer can avoid surgery, chemotherapy, and radiation.

MRgFUS is an outpatient treatment that takes about two hours. Patients under anesthesia are placed in an MRI machine that covers the lower half of the body. After the machine takes an image of the prostate, the doctors outline the treatment area and deliver the focused ultrasound waves, guided by the MRI. The ultrasound waves come from different directions, intersecting to attack and kill the cancer by heating the cells to more than 158 °F (70 °C).

In the phase 2 clinical trial, 101 men received the novel MRgFUS treatment and then were biopsied six months and 24 months later. There was no intermediate- or higher-risk cancer left in the treated area for 88% of the patients. Based on this data, the FDA in December 2021 granted approval for the technology, called Exablate Prostate, to treat prostate tissue. The FDA also approved an investigator-initiated trial to compare MRgFUS focal therapy to active surveillance and demonstrate a clinical benefit for patients with prostate cancer. Using MRgFUS for intermediate-risk cancers has become possible due to two important developments over the past 15 years. First, there was an acceptance by experts of using active surveillance for low-grade tumors. The second advance was new imaging technology that enabled MRIs to be incorporated into ultrasound treatment.

“We believe this novel treatment strategy will improve the lives of many prostate cancer patients,” said MSK urologic cancer surgeon Behfar Ehdaie who led the phase 2 trial. “To draw a parallel with how breast cancer treatment changed 30 years ago, you could think of focal therapy as a ‘male lumpectomy.’ Instead of removing all the tissue in a breast or prostate, we have learned that it is safe and effective to treat specific areas and greatly reduce the burden on patients.”

“Advancements in prostate cancer over the past two decades have been headlined by successes that have benefited all patients, and now focal therapy provides another exciting area that can move the needle in prostate cancer management,” Dr. Ehdaie added.

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54 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

55 (332.83233642578): SELECT name FROM jos_deeppockets WHERE id=294793457 LIMIT 1

56 (313.99726867676): SELECT name FROM jos_deeppockets_archive WHERE id=294793457 LIMIT 1

57 (73.19450378418): 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 (92.029571533203): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

59 (574.11193847656): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

60 (!!!!! 1734.0183258057): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

61 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

62 (158.07151794434): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

63 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

64 (112.05673217773): 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 (595.0927734375): SELECT fid FROM jos_deeppockets WHERE id=294793457 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793457 AND published='1' LIMIT 1

66 (67.949295043945): 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 (62.942504882812): select jos_twitters.link from jos_twitters where cat=10

68 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

69 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

70 (45.061111450195): select jos_linkedin.link from jos_linkedin where cat=10

71 (36.954879760742): SELECT fid FROM jos_deeppockets WHERE id=294793457 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793457 AND published='1' LIMIT 1

72 (33.855438232422): 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 (337.83912658691): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (224.11346435547): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (40.054321289062): 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 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (49.114227294922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (33.140182495117): 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 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

108 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

109 (68.187713623047): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (48.87580871582): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

112 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

113 (571.01249694824): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (492.09594726562): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (61.988830566406): 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=294793413 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (383.13865661621): 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=294793413 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (742.91229248047): 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

118 (509.97734069824): 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

119 (147.81951904297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

120 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

121 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

122 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

123 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

124 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

125 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

126 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

127 (346.89903259277): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

128 (!!!!! 24297.952651978): 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

129 (720.02410888672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793457 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793457 AND type='deeppockets_item' AND published='1' LIMIT 1

130 (!!!!! 8485.0788116455): ( 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

131 (94.175338745117): ( 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

132 (87.02278137207): 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

133 (36.001205444336): 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

134 (77.009201049805): 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

135 (46.014785766602): 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

136 (436.06758117676): 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

137 (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

138 (45.061111450195): 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

139 (29.802322387695): 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

140 (546.93222045898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (510.93101501465): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

142 (68.187713623047): SELECT name FROM jos_deeppockets WHERE id=214

143 (46.014785766602): SELECT name FROM jos_deeppockets WHERE id=214

144 (695.94383239746): 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

145 (653.02848815918): 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

146 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

147 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

148 (!!!!! 9994.0299987793): TRUNCATE TABLE jos_trademed_module

149 (123.02398681641): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (82.015991210938): 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=294793457 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

151 (538.11073303223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

153 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

154 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

155 (!!!!! 1574.9931335449): 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

156 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

157 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

158 (72.002410888672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793457 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793457 AND type='deeppockets_item' AND published='1' LIMIT 1

159 (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=0 or channel_id is null)

160 (36.954879760742): 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=0 or channel_id is null)

161 (44.107437133789): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

162 (550.98533630371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

163 (107.0499420166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793457 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793457 AND published='1' LIMIT 1

164 (75.101852416992): select jos_twitters.link from jos_twitters where cat=10

165 (38.862228393555): select jos_facebook.link from jos_facebook where cat=10

166 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

167 (40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10

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