The integration of 3D-imaging functionality into C-arm systems combines advantages of interventional X-ray systems, e.g. good patient access and live fluoroscopy, with 3D imaging capabilities similar to those of a CT-scanner. To date 3D-imaging with a C-arm system has been mainly used to visualize high contrast objects. However, the advent of high quality flat panel detectors improves the low contrast imaging capabilities. We discuss the influence of scattered radiation, beam hardening, truncated projections, quantization and detector recording levels on the image quality. Subsequently, we present algorithms and methods to correct these effects in order to achieve low contrast resolution. The performance of our pre- and post-reconstructive correction procedures is demonstrated by first clinical cases.