A system and method for detecting central pulmonary embolisms in a subject's vasculature is provided. In some aspects, the method includes receiving, using the input, a set of images representing a vasculature of the subject's lungs, automatically analyzing the set of images to segment the main arteries associated with the subject's lungs and separate the main arteries from surrounding tissues. The method also includes automatically extracting central pulmonary embolism candidates from the set of images after segmenting and separating the main arteries, and automatically evaluating the central pulmonary embolism candidates in three-dimensional (3D) space by applying a series of rules. The method further includes automatically displaying a report indicating evaluated central pulmonary embolism candidates on a display.