Computer simulations of lung nodules overcome many shortcomings of creating radiographs using anthropomorphic nodule phantoms for lung nodule detection studies, but these algorithms can be cumbersome and involved. A simple, fast, and flexible computer program to simulate lung nodules in digital chest radiographs for detection studies is reported. To verify the realism of the simulated nodules, a psychophysical study and a statistical study were conducted. In the psychophysical study, six radiologists and four nonradiologists were asked to distinguish between 17 real lung nodules and 17 computersimulated lung nodules shown in eight radiographs. The results show that the computer-simulated lung nodules are indistinguishable visually from real lung nodules. Using parameters from the Rose model of vision, results show that the simulated and real nodules are the same statistically. Thus, besides visual validity, statistical analysis in confirming the validity of the simulated lung nodules is included. © Lippincott-Raven Publishers.