Coronary calcium testing is a CT technology. Therefore, there is significant radiation. Many people warn of the risk. It has been estimated as 1 in 1000 LIFETIME risk of cancer.

However, look at the comparison. The risk of heart attack and stroke with untreated plaque is 40% to 80% IN 10 YEARS. We're talking very different ballparks of risk; although there is radiation risk, it's nowhere near the risk we're stratifying with cardiovascular disease. The risk does underline a significant point about use.

Have you wondered why you don't see nomograms starting at age 5 or even 1 for calcium scores? The radiation risk. A nomogram is an age curve. It's drawn from the results of large studies of normals. Because of the radiation, you'll never see nomogram studies of young healthy people with Calcium scores.

Coronary calcium score has some risk from radiation, but it's negligible compared to having plaque in your arteries. By far the most commonly used screening tool is a stress test. I usually don't recommend it. The false-negative rates are way too high, resulting in common examples of events and death following a false negative stress test. A well-known example happened with news anchor Tim Russert.

CIMT also has challenges with the standardization of techniques & interpretation. But by far the biggest challenge with CIMT is accessed. It's by far the best screening tool. And, by the way - there is no radiation - it's ultrasound.