A medical imaging phantom (18) is three-dimensionally printed (36). In one specific approach, three-dimensional printing (36) allows for any number of variations in phantoms (18). A library of different phantoms (18), different inserts, different textures, different densities, different organs, different pathologies, different sizes, different shapes, and/or other differences allows for defining a specific phantom (18) as needed. The defined phantom (18) is then printed (36) for calibration or other use in medical imaging.