Optical tomography is a potential diagnostic method for visualizing optical properties of tissues in vivo. We present an optical tomography method that has been designed for imaging of the human testes, particularly for spectroscopic tumor differentiation. In this application we need to compute three-dimensional distributions of the optical contrast (absorption coefficient) in the tissue in real time. Thus we have given special care to elaborate an efficient inverse algorithm that takes the limitations of spatial resolution and data space point density into account. Our inverse solution is based on a linearization approach and a dedicated object space discretization. Furthermore, we introduce the concept of fuzzy voxels, which enables a reconstruction-inherent image smoothing.