Aims and objectives The low contrast-detail detectability method using contrast-detail (CD) phantoms such as CDRAD phantom is established as a method utilised for comparison of image quality for imaging systems and/or imaging protocols/techniques and acquisition parameters [1, 2]. This method has the advantage of assessing the whole imaging chain, including the human observer [3]. However, the phantoms used with this method (eg CDRAD phantom) are homogeneous phantoms and do not consider the influence of anatomical noise which arises from human anatomy. Therefore, it is unclear whether this approach (LCD detectability) has a correlation with the visual image quality and visual lesion visibility, and also the validity of utilising this method in optimisation studies is questionable [4]. View article