Financial communication & shareholder insight (Euronext Growth: ALMKT)
A pancreatic cystic lesion, often simply called a cyst, is usually found by chance. Is it dangerous? With ultrasound alone, the physician cannot always tell. Before comparing the images, here is where we are looking, in three steps.
The physician reaches it endoscopically: an ultrasound scope goes through the mouth down to the stomach.
From the stomach, it sends ultrasound (blue area) toward the pancreas and shows the cyst. This is the ultrasound image in the inset, and the left-hand image of the slider.
A fine needle crosses the wall into the cyst (close-up). The Cellvizio probe is passed through it and touches the wall: the inset shows what it films, the right-hand image of the slider.
The 0.85 mm Cellvizio probe passes through a needle about 1 mm wide, which itself slides through the channel of the ultrasound scope. That is how a microscope reaches the cyst wall, endoscopically.
It is the appearance of the wall, as seen by Cellvizio, that guides the diagnosis.
Features described in the literature, to be interpreted by the physician within the complete workup: Napoléon B. et al., Surgical Endoscopy 2016. Cellvizio images from the AQ-Flex 19 brochure, Mauna Kea Technologies.
Pancreatic cystic lesions are often found by chance, on a scan done for another reason. Most are benign; some can progress to cancer.
When standard tests cannot settle the question, some patients undergo surgery as a precaution although their cyst was harmless, while other high-risk cysts are not identified in time.
With Cellvizio, the physician slides a 0.85 mm optical probe through the aspiration needle and looks directly at the cyst wall, at the cellular level.
71%
accuracy of standard cyst fluid analysis (CEA and cytology) in distinguishing mucinous from non-mucinous cysts (INDEX study, n = 144).
60%
of patients with a benign serous cyst undergo unnecessary surgery because of diagnostic uncertainty (Jais et al., Gut 2016, n = 2,622).
40–78%
of surgically removed cysts show neither cancer nor high-grade dysplasia, or nearly 1,850 unnecessary surgeries a year in the United States (Sharib et al., Surgery 2020).
28–37%
postoperative complication rate (morbidity) after pancreatic resection (Krishna Lab, Ohio State University; Jais et al., Gut 2016).
Sources: INDEX study, Krishna et al., Clinical Gastroenterology and Hepatology 2020; Jais et al., Gut 2016; Sharib et al., Surgery 2020; Krishna Lab, The Ohio State University.
Prospective single-center INDEX study (Krishna et al., Clinical Gastroenterology and Hepatology 2020, n = 144, Ohio State University). The prospective multicenter CONTACT 2 study (Napoléon et al., Endoscopy 2018, n = 206) reports 100% specificity for serous cysts.
Ten-year retrospective observational study (2014–2024) of 455 cysts evaluated at Ohio State University, comparing the periods before and after adoption of a multimodal diagnostic approach including Cellvizio EUS-nCLE (presented by Dr. S. Krishna at DDW 2026). The decline came with no increase in missed resections. The Krishna Lab
Documented case — UCLH
“It felt like my life was on hold.”
A CT scan reveals a cyst on the pancreas of Linda B., 41.
At University College London Hospital, Dr. Stephen Pereira examines her as part of a clinical study. Cellvizio endomicroscopic imaging revealed the characteristic superficial vascular network, orienting the diagnosis toward a benign serous cyst and allowing the medical team to rule out major surgical resection.
“It gave me peace of mind,” she says.
This case describes an individual patient journey, documented as part of a clinical study in the United Kingdom. It does not predict the outcome of an exam for any other patient.
Pancreatic cysts are our leading clinical pillar in the United States. Four factors make it a significant market.
3–10%
of adults have an incidentally discovered pancreatic cyst, from 2.6% on CT across all ages up to 8.7% between ages 80 and 89.
~100,000
patients a year who could benefit from Cellvizio in the United States, our largest market (67% of revenue in the first nine months of 2026).
CLIMB · ESGE
by the largest U.S. study (CLIMB: 526 patients, 14 centers, ASGE Presidential Plenary at DDW 2026) and included in the European ESGE technical guidelines.
CPT 43252
An established Category I procedure code allows U.S. facilities to bill for the exam under payers’ fee schedules. Each exam uses a probe, a source of recurring revenue.
Sources: corporate presentation, October 2025, and Laffan et al., AJR 2008; Company estimate, 2025 annual report; nine-month sales press release, October 20, 2026; Cellvizio reimbursement fact sheet, United States.
The clinical studies online
Dr. Somashekar Krishna’s laboratory at The Ohio State University Wexner Medical Center focuses on the early detection of pancreatic lesions and their organ-preserving endoscopic treatment. Its website brings together in one place its research programs, clinical trials, publications and the international consortium it leads: the best entry point to follow studies of Cellvizio in pancreatic cystic lesions.
This work reaches well beyond one hospital. Each year at DDW, Dr. Krishna convenes the DDW Pancreatic Cyst Consortium: born as the investigators’ meeting of a multicenter Cellvizio study, it drew 123 registrants from more than 12 countries in 2026.
In the episode “Earlier, More Accurate Detection of Pancreatic Cancer,” Dr. Anjuli Luthra, co-author of several studies with Dr. Krishna’s team, explains how real-time microscopic imaging helps physicians decide between surveillance, intervention and surgery.
Audience measurement
With your consent, we use Google Analytics to find out how many people visit this page. If you decline, no measurement cookie is set. Cookie policy
