Electron beam computed tomography (EBCT) has provided a new tool for identification and possible quantification of coronary arterial plaque calcium. EBCT is the only imaging modality currently available which generates images of the spatial, temporal, and contrast resolution required for the identification of small foci of calcium and the potential for accurate quantification of calcium. Meanwhile, interest in quantification of coronary arterial calcium via EBCT and its correlation with severity of coronary atherosclerosis is increasing. Data remain inconclusive, but it appears that the reproducibility of quantitative grading of the extent of calcification by EBCT may be limited, in part, by the arbitrary nature of the scoring algorithm employed within the analysis tools currently provided by the EBCT manufacturer. It has not been possible to objectively determine optimum values for minimum plaque area and brightness threshold or to quantitatively determine whether single optimal values even exist. Also, although the current system tabulates the score, area, and mean attenuation for each plaque, the locations of the plaques are not reported.