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Abbreviations: CTPA, computed tomography pulmonary angiography; PE, pulmonary embolism; RCR, royal college of radiologists; NICE, national institute for clinical excellence; NHS, national health servicE IntroductionThe RCR advise that the timeframe between receipt and acceptance of an inpatient CTPA and issuing of the report should be one working day, with a recommended target rate of 90%.1 We sought to determine whether this target was achieved within Sandwell and West Birmingham NHS Trust, specifically within the City Hospital site. Our study focuses on the pathway between request and scan, to determine whether the entire process of handling CTPA requests can become more streamlined and thus improve patient care.A PE occurs when a blood clot, usually a deep vein thrombus from the leg, travels within the bloodstream and lodges within part of the pulmonary arterial network. Although symptoms can be non-specific, a PE commonly results in acute shortness of breath and/or chest pain, but symptoms can also include tachycardia, tachypnoea, haemoptysis, a sense of apprehension and, more rarely, syncope which suggests a larger clot and a poorer prognosis. 2Due to the non-specific nature of the symptoms, diagnosing a PE is not always possible clinically. Clinical suspicion relies on history, examination, relevant blood tests including D-dimer where appropriate and when a PE is considered likely, further imaging should be considered to establish a definitive diagnosis. The chance of an abnormal clot forming and subsequently lodging in the pulmonary vasculature is more likely when the components of Virchow's triad are present, 3 namely; stasis of blood flow, endothelial injury and hypercoagulability. Hence malignancy, significant immobility, major surgery, recent fracture, pregnancy, blood disorders are among the common causes of abnormal clot formation.It is for this reason that the Wells score -a clinical prediction ruletakes into account some of these factors in determining the likelihood of a PE which, together with clinical judgement, point toward or away from further investigations. A CTPA is the gold standard imaging modality in patients who have a clinically likely acute PE, 4 or a suspected PE with an unlikely Wells score but a positive D-dimer, and according to NICE guidelines it should occur immediately. 5 In the interim period while awaiting a scan, treatment with an appropriate anticoagulant should begin. Methods and materialsWe initially analysed retrospective data from 400 in patients who were being investigated for possible PE. This was done using CRIS AbstractIntroduction : In-patient requests for CTPA should be performed and reported within one working day of receipt and acceptance of the request form, with a target of 90%.