ABSTRACT: We studied the reliability of radiomic features on abdominal computed tomography (CT) images reconstructed with multiple CT image acquisition settings using the ACR (American College of Radiology) CT Phantom. Twenty-four sets of CT images of the ACR CT phantom were attained from a GE Discovery 750HD scanner using 24 different image acquisition settings, combinations of 4 tube currents (25, 50, 100, 200 Effective mAs), 3 slice thicknesses (1.25, 2.5, 5 mm), and 2 convolution kernels (STANDARD and SOFT). Polyethylene (-95 HU) and acrylic (120 HU) of the phantom model were selected for calculating real feature value; a noise-free, computer-generated phantom image series that reproduced the 2 objects and the background was used for calculating reference feature value. Feature reliability was defined as the degree of predicting reference feature value from real feature value. Radiomic features mean, std, skewness, kurtosis, gray-level co-occurrence matrix (GLCM)-energy, GLCM-contrast, GLCM-correlation, GLCM-homogeneity were investigated. The value of R 2 ? 0.85 was considered to be of high reliability. The reliability of mean and std were high across all image acquisition settings. At 200 Effective mAs, all features except GLCM-homogeneity showed high reliability, whereas at 25 Effective mAs, most features (except mean and std) showed low reliability. From high to low, reliability was ranked in the following order: mean, std, skewness, kurtosis, GLCM-energy, correlation, contrast and homogeneity. CT image acquisition settings affected the reliability of radiomic features. High reliable features were attained from images reconstructed at high tube current and thick slice thickness.