Texture analysis for lung lesions is sensitive to changing imaging conditions but these effects are not well understood, in part, due to a lack of ground-truth phantoms with realistic textures. The purpose of this study was to explore the accuracy and variability of texture features across imaging conditions by comparing imaged texture features to voxel-based 3D printed textured lesions for which the true values are known. The seven features of interest were based on the Grey Level Co-Occurrence Matrix (GLCM). The lesion phantoms were designed with three shapes (spherical, lobulated, and spiculated), two textures (homogenous and heterogeneous), and two sizes (diameter < 1.5 cm and 1.5 cm < diameter < 3 cm), resulting in 24 lesions (with a second replica of each). The lesions were inserted into an anthropomorphic thorax phantom (Multipurpose Chest Phantom N1, Kyoto Kagaku) and imaged using a commercial CT system (GE Revolution) at three CTDI levels (0.67, 1.42, and 5.80 mGy), three reconstruction algorithms (FBP, IR-2, IR-4), four reconstruction kernel types (standard, soft, edge), and two slice thicknesses (0.6 mm and 5 mm). Another repeat scan was performed. Texture features from these images were extracted and compared to the ground truth feature values by percent relative error. The variability across imaging conditions was calculated by standard deviation across a certain imaging condition for all heterogeneous lesions. The results indicated that the acquisition method has a significant influence on the accuracy and variability of extracted features and as such, feature quantities are highly susceptible to imaging parameter choices. The most influential parameters were slice thickness and reconstruction kernels. Thin slice thickness and edge reconstruction kernel overall produced more accurate and more repeatable results. Some features (e.g., Contrast) were more accurately quantified under conditions that render higher spatial frequencies (e.g., thinner slice thickness and sharp kernels), while others (e.g., Homogeneity) showed more accurate quantification under conditions that render smoother images (e.g., higher dose and smoother kernels). Care should be exercised is relating texture features between cases of varied acquisition protocols, with need to cross calibration dependent on the feature of interest.