Monaco treatment planning system tools and optimization processes.

The Monaco treatment planning system combines Monte Carlo dose calculation accuracy with robust optimization tools to provide high-quality radiotherapy treatment plans for three-dimensional conformal radiotherapy (3D CRT), intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). Recent technology advances have allowed for fast calculation speeds, which allow clinicians and patients to benefit from the accuracy of the Monte Carlo algorithm while reducing overall planning time. A collection of biological and physical dose-based planning tools and templates simplify the planning process and allow for consistent results across organizations. At the same time, multicriteria optimization (MCO) ensures critical organs are spared to the greatest possible degree while maintaining target coverage. Monaco encompasses a full suite of treatment modalities, including conventional radiotherapy and particle therapy, and is paving the way for real-time adaptive treatments with developments in magnetic resonance (MR)-guided radiation therapy.