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EBCT has undergone a 20-year period of testing for reliability and validity and is now established as a useful technique in identifying individuals with or at risk for CHD. MDCT is a promising tool for coronary calcium scoring while additional studies evaluating progression, reproducibility, and outcomes are currently under way. Radiation doses, reproducibility, and validation studies must be taken into account when choosing a cardiac CT study. Serial coronary calcium scans to noninvasively assess progression rates of coronary calcium and CT angiography to assess NCP are now starting to be reported, but the data are premature at this time. The most promising use of these technologies is calcium scoring for risk assessment of the asymptomatic individual, whereby elevated calcium scores may trigger more vigorous application of both lifestyle and/or pharmacological therapies targeted to lower cardiovascular risk and CT angiography to rule out the presence of coronary stenoses in certain subsets of symptomatic patients.