Coronary artery calcification (CAC) is associated with major adverse cardiovascular events.^{1 – 3} To date, the clinical impact of arterial calcification on local plaque vulnerability remains unclear,⁴ but the extent of CAC is associated with worse outcomes in the general population and in patients undergoing revascularization.^5,6 In addition, the presence of calcifications leads to under-expansion during percutaneous coronary intervention (PCI).⁷ The previous study demonstrated that severely calcified plaques undergoing PCI were associated with higher procedural complications and lower success rates.⁸ Hence, detection of calcified region is important for PCI treatment. For example, in the heavily calcified lesions, it is hard to cross or dilate a coronary stenosis with PCI devices such as balloons or stents.⁹ However, rotational atherectomy facilitates delivery or expansion for the treatment of complex calcified lesions. Furthermore, other available treatment strategies such as cutting and scoring balloons improve vessel compliance by creating discrete incisions instead of producing small particles to ablate the heavily calcified plaque for rotablation.⁴ For above reasons, a cardiologist pays more attention to the calcified lesion when making a clinical decision. Therefore, accurate identification and quantification of calcified lesion is crucial when treating patients with advanced coronary atherosclerosis.