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T issue Imaging with CARS Micr oscopy   333


        simultaneously. Indeed, in one of the first rapid CARS imaging stud-
        ies of living cells, the CARS technique was combined with simultane-
        ous two-photon-excited fluorescence lifetime microscopy (FLIM). 34
        Other examples include multimodal imaging based on CARS, TPEF,
        SHG, and sum frequency generation (SFG) microscopy. 65,84
            The CARS imaging microscope enables a complete multimodal
        investigation of tissues based on endogenous contrast. In addition to
        the chemical selectivity offered by CARS, simultaneously detected
        SHG signals reveal tissue collagen patterns and TPEF signatures
        report on endogenous fluorophores such as elastin fibers and nicotin-
        amide adenine dinucleotide (NAD) metabolic agents. 85,86  The CARS
        microscope thus constitutes the ultimate nonlinear imaging platform.

   11.6 CARS in Tissues
        The major difference between thin samples (μm sized) and tissues is
        the presence of significant light scattering in the latter. Light scatter-
        ing is a consequence of variations in the linear refractive index in the
        sample. In tissues, refractive index variations result from large struc-
        tures such as extracellular fibers and smaller structures such as intra-
        cellular organelles in an otherwise aqueous environment. In addition,
        light absorption is also relevant for thicker tissues. Both light scatter-
        ing and absorption give rise to signal loss in tissues relative to thin
        samples. The consequences of these linear optical effects on the CARS
        signal will be discussed below.

        11.6.1 Focusing in Tissues
        Optimum CARS signals are obtained when the incoming light is con-
        densed into a tight focal spot. Naturally, light scattering in tissues
        compromises the formation of a clean focal spot. The reason for this
        is twofold. First, scattering of excitation light in the tissue leads to loss
        of amplitude in the vicinity of the focal volume. 87–89  Second, the phase
        of the incident waves will be compromised upon arrival in the focal
        region. The focal volume, which exists by virtue of constructive inter-
                                             90
        ference of light waves in one point in space,  is very sensitive to the
        coherence of the incoming light. Loss of phase coherence implies that
        the waves will be unable to completely interfere to produce a tight
        focal spot. Hence, in the presence of scattering, the focal volume will
        be smeared out and contain a lower excitation density. CARS signals
        are directly affected and generally much lower if tissue scattering is
        significant.
            Using NIR radiation, appreciable CARS signals up to 0.25 mm can
        generally be produced in most tissue types. Special long working dis-
        tance objectives can often be used to increase this penetration depth by
        a factor of two. Beyond 0.5 mm, light scattering severely complicates
        the formation of a sufficiently tight focal spot for CARS generation. To
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