The application of optical-CT scanning to achieve accurate high-resolution 3D dosimetry is a subject of current interest. The purpose of this paper is to provide a brief overview of past research and achievements in optical-CT polymer gel dosimetry, and to review current issues and challenges. The origins of optical-CT imaging of light-scattering polymer gels are reviewed. Techniques to characterize and optimize optical-CT performance are presented. Particular attention is given to studies of artifacts in optical-CT imaging, an important area that has not been well studied to date. The technique of optical-CT simulation by Monte-Carlo modeling is introduced as a tool to explore such artifacts. New simulation studies are presented and compared with experimental data.