The noninvasive assessment of coronary atherosclerosis holds great promise for the future of cardiovascular medicine, and multidetector computed tomography (MDCT) has recently taken the lead in this area. Earlier studies have shown the ability of MDCT to visualize the coronary lumen and various types of atherosclerotic plaque. The aims of this project are to design, implement, and validate a complete system for the automated, quantitative analysis of coronary MDCT images. The developed system uses graph algorithms and knowledge-based cost functions to automatically segment the lumen and wall, and then uses pattern classification techniques to identify and quantify the tissue types found within the detected vascular wall. The system has been validated in comparison with expert tracings and labels, as well as in comparison with intravascular ultrasound (IVUS). In the former, the radial position of the lumen and adventitia were compared at 360 corresponding angular locations in 299 vascular cross sections (from 13 vessels in 5 patients: 5 RCA, 4 LAD, 4 LCX). Results show a border positioning error of 0.150 ± 0.090 mm unsigned / 0.007 ± 0.001 mm signed for the lumen, and 0.210 ± 0.120 mm unsigned / 0.020 ± 0.030 mm signed for the vessel wall. In the comparison with IVUS, the luminal and vascular cross sectional areas were compared in 7 vessels; good correlation was shown for both the lumen (R=0.83) and the vessel wall (R=0.76). The plaque characterization algorithm correctly classified 92% of calcified plaques and 87% of non-calcified plaques.