Figure 1a. Poor lesion visualization at US-guided biopsy performed with the multipass automated gun technique. (a) US image of the breast shows numerous echogenic specular reflectors (arrow) corresponding to clustered microcalcifications against a hypoechoic background. (b) On a US image obtained after the first pass of the core biopsy needle through the microcalcifications, bright hyperechoic air in the biopsy track (arrows) mimics and obscures the targeted microcalcifications.