Digital flat-panel-based volume CT (VCT) represents a unique design capable of ultra-high spatial resolution, direct volumetric imaging, and dynamic CT scanning. This innovation, when fully developed, has the promise of opening a unique window on human anatomy and physiology. For example, the volumetric coverage offered by this technology enables us to observe the perfusion of an entire organ, such as the brain, liver, or kidney, tomographically (e.g., after a transplant or ischemic event). By virtue of its higher resolution, one can directly visualize the trabecular structure of bone. This paper describes the basic design architecture of VCT. Three key technical challenges, viz., scatter correction, dynamic range extension, and temporal resolution improvement, must be addressed for successful implementation of a VCT scanner. How these issues are solved in a VCT prototype and the modifications necessary to enable ultra-high resolution volumetric scanning are described. The fundamental principles of scatter correction and dose reduction are illustrated with the help of an actual prototype. The image quality metrics of this prototype are characterized and compared with a multi-detector CT (MDCT).