Imaging Features of AlloDerm(®) Used in Postmastectomy Breast Reconstructions

The purpose of this pictorial essay is to demonstrate the imaging features (ultrasound, mammogram, and magnetic resonance imaging (MRI)) of AlloDerm(®)(LifeCell Corp.; Branchburg, NJ), an acellular dermal matrix sometimes used in both primary and reconstructive breast surgeries. AlloDerm(®) is derived from cadaveric dermis and provides an immunologically inert scaffold in tissue reconstruction. Since there is little literature on the imaging of this substance, radiologists may be unfamiliar with its appearance in breast imaging. For this manuscript, ex vivo and in vivo images of AlloDerm(®) in postmastectomy patients were evaluated using different imaging modalities. The appearance of AlloDerm(®) can vary based on length of time postsurgery and incorporation into the host. AlloDerm(®) appears as an isodense to glandular tissue on a mammogram and isoechoic to glandular tissue on ultrasound imaging. On MRI, in comparison with normal breast parenchyma, AlloDerm(®) is hyperintense on T2-weighted imaging and isointense on T1-weighted imaging and demonstrates mild enhancement. To the best of the authors' knowledge, this is the first multimodality imaging description of AlloDerm(®) used in postmastectomy patients. The conformation of AlloDerm(®) at surgical placement and the degree of host cell migration and neoangiogenesis are factors to take into consideration when performing diagnostic evaluations; and, familiarity with the various imaging appearances of AlloDerm(®) can be helpful to exclude residual or recurrent disease.