In the beginning of 2004 medical spiral-CT scanners that acquire up to 64 slices simultaneously became available. Most manufacturers use a straightforward acquisition principle, namely an x-ray focus rotating on a circular path and an opposing cylindrical detector whose rotational center coincides with the x-ray focus. The 64-slice scanner available to us, a Somatom Sensation 64 spiral cone-beam CT scanner (Siemens, Medical Solutions, Forchheim, Germany), makes use of a flying focal spot (FFS) that allows for view-by-view deflections of the focal spot in the rotation direction (/spl alpha/FFS) and in the z-direction (zFFS) with the goal of reducing aliasing artifacts. The FFS feature doubles the sampling density in the radial direction (channel direction, /spl alpha/FFS) and in the longitudinal direction (detector row direction or z-direction, zFFS). The cost of increased radial and azimuthal sampling is a two- or four-fold reduction of azimuthal sampling (angular sampling). To compensate for the potential reduction of azimuthal sampling the scanner simply increases the number of detector read-outs (readings) per rotation by a factor two or four. Then, up to four detector readings contribute to what we define as one view or one projection. A significant reduction of in-plane aliasing and of aliasing in the z-direction can be expected. Especially the latter is of importance to spiral CT scans where aliasing is known to produce so-called windmill artifacts. We have derived and analyzed the optimal focal spot deflection values /spl part//spl alpha/ and /spl part/z as they would ideally occur in our scanner. Based upon these we show how image reconstruction can be performed in general. A simulation study showing reconstructions of mathematical phantoms further provides evidence that image quality can be significantly improved with the FFS. Aliasing artifacts, that manifest as streaks emerging from high-contrast objects, and windmill artifacts are reduced by almost an order of magnitude with the FFS compared to a simulation without FFS. Patient images acquired with our 64-slice cone-beam CT scanner support these results.