Amongst the advanced cardiac imaging modalities, multislice computed tomography (MSCT) coronary angiography is emerging as a reliable non-invasive method for the assessment of coronary artery disease (CAD), coronary anatomy and cardiac function [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Improvements in computed tomography technology hold the promise of replacing the standard invasive procedure of conventional coronary angiography in selected patient groups. Multiple studies involving over several thousands of patients have established that MSCT angiography is highly accurate for delineation of the presence and severity of coronary atherosclerosis [18][19][20][21][22][23]. The technique provides independent prognostic information over baseline clinical risk factors in patients with known and suspected CAD [24]. MSCT may also reveal the total plaque burden, i.e., both calcified and non-calcified components, for individual patients with coronary atherosclerosis [25][26][27][28][29][30][31][32]. This holds in particular for detecting patients with left main disease as this disease is associated with a poor prognosis. Timely detection of atherosclerosis of the left main stem is crucial as it may determine future interventional therapy. The standard of care for left main coronary artery disease is coronary artery bypass surgery (CABG), but technical advances in percutaneous coronary intervention (PCI) and stenting technology have emboldened the interventional cardiology community to test the feasibility of and document the procedural results for stenting the left main coronary artery [33][34][35][36]. MSCT may therefore play an important role for guiding interventional therapy by early detection and establishing the severity and extent of coronary atherosclerosis of the left main coronary artery.Rodriquez-Granillo et al.[34] explored the differences in plaque burden at different segments of the left main bifurcation and its relationship with the bifurcation angle using high-resolution MSCT. A total of 50 patients were evaluated using a 40-row MSCT scanner. The localization, severity and distribution of plaques within the left main bifurcation were determined. Seventeen (34%) patients presented wall irregularities in the left main stem and in the ostial left circumflex coronary artery, whereas the ostial left descending coronary artery was affected in 32 (64%) patients. More than 90% of plaques were located opposite to the flow divider. Of the 18 patients with a normal ostial left anterior descending coronary artery, 13 (72%) had a bifurcation angle \88.5°, whereas the 63% of the patients with any disease of left anterior descending coronary artery had an angle C88.5°(P = 0.018). At the left main bifurcation, atherosclerotic plaques were commonly eccentric and located opposite to the flow divider. A Editorial comment to the article of Gemici et al.