We investigated the effects of structured background noise on the detectability of stenotic lesions. Digital subtraction angiographic (DSA) images of stenotic blood vessels were simulated and superimposed onto uniform noise samples. Eighteen-alternative forced choice (18-AFC) experiments were employed to determine the detectability of the stenotic lesion in the structured-noise background of a blood vessel. In this study, the dependence of detectability on lesion size, vessel size, and incident x-ray exposure was examined. Our results indicate that the presence of structured noise in an image will reduce the detectability of a lesion. However, the relative performance of an observer when the lesion size and incident exposure were varied was the same with and without the presence of the structured background. Thus, conclusions obtained previously with regard to changes in the detectability of a lesion in the presence of uniform background noise can be applied directly to conditions in which simple structured anatomic background is present.