The development of CT technology, the more widespread use of spiral CT and the application of contrast injection techniques now enable such levels of contrast intensity in the segmental and larger pulmonary arteries to be attained as to allow the minimally invasive, direct detection of emboli. This technique has a role to play in the strategy for check-up examinations for pulmonary embolism. By providing a realistic alternative the spiral CT examination serves to reduce the number of scintigraphy examinations to be performed. At the same time, the role played by invasive pulmonary angiography examinations is now shifting towards intervention.