Although multislice CT seems to have little value in most candidates for invasive coronary angiography, I believe that it can be useful in an important, albeit small, subset of patients with chest pain. As shown in Dewey and colleagues' Figure 3, negative results on multislice CT are associated with post-test probability of CAD below 10% only in patients whose pretest probability of CAD was less than 50%. Achieving a post-test probability below 5% requires a pretest probability below 30%, as would occur in a man or a woman with nonspecific chest pain and equivocal results on functional noninvasive testing. A CAD diagnosis might be important to establish anatomically, especially if the patient's symptoms require multiple physician or emergency department visits or hospitalizations. According to Dewey and colleagues, such patients commonly undergo invasive coronary angiography in Germany. In these patients with low pretest probability, in whom the response to treatment and other noninvasive tests is inconclusive, multislice CT results will usually be negative and the post-test probability of CAD will be low enough to forgo invasive coronary angiography and yet reassure the patient. Appropriate use of multislice CT in such patients requires a careful clinical assessment of probabilities (4) as well as a properly conducted work-up with functional tests, as outlined in current American College of Cardiology/American Heart Association guidelines ((1), (5)).