Artificial CT images can enhance variation of case images in diagnostic radiology skills training.

"all code necessary to replicate our results is provided at https://github com/ut-ram-aim/realism-study ."

"Declarations Ethics approval and consent to participateNo ethical approval was required since publicly available data is used. Consent for publicationNot applicable. Competing interestsRV is supported by an institutional research grant from Siemens Healthineers.EISH is supported by a ZonMw Innovative Medical Devices Initiative (IMDI) subsidy for the B3CARE project (Dossier number: 10-10400-98-008). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors declare that they have no competing interests. Competing interests RV is supported by an institutional research grant from Siemens Healthineers. EISH is supported by a ZonMw Innovative Medical Devices Initiative (IMDI) subsidy for the B3CARE project (Dossier number: 10-10400-98-008). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors declare that they have no competing interests."

"Funding EISH is supported by a ZonMw Innovative Medical Devices Initiative (IMDI) subsidy for the B3CARE project (Dossier number: 10-10400-98-008). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."