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To recover absolute blood oxygenation from high resolution PAT images, the fluence needs to be corrected. However, qPAT is a large scale inverse problem. Finite difference gradient methods or gradient-free parameter searches are unsuitable for inverting 3D images. Adjoint methods by contrast provide the parameter search gradient efficiently. An adjoint radiative transfer equation formulation using a Monte-Carlo fluence approximation is used and validated in silico and on tissue phantom data. Convergence and limitations are discussed.