Towards integrated and personalized treatment management

with Monaco 6® and Elekta ProKnow®


Increasing demand for radiation therapy around the world creates a need for more workflow oriented, better integrated, and automated solutions for treatment planning and management.

In the event film above, we have gathered the experience of various experts from around the globe to discuss the opportunities and solutions that exist today and how they can make a difference to you, and to your patients.

We look forward to bringing you along with us on this journey towards more integrated and personalized treatment management.

Join Elekta Planning Academy

High-precision treatment planning for radiation therapy with Monaco® 6

Monaco® has recently embraced significant transformations with two major releases and an immediate impact on both workflow efficiency and planning quality.

Monaco 6 delivers intuitive planning functionality for a broad range of treatments, from 3D conformal to stereotactic techniques, with integrated MOSAIQ® data management, auto-planning and unique proton planning capabilities.

Monaco® 6 has CE mark, U.S. 510(k) Clearance and Health Canada Medical Device License. Not available in all markets.

Simplified daily workflow

Transition to Monaco allows huge time savings

Matthew Price

“Integration with MOSAIQ was one of the main drivers for our transition to Monaco.”

Matthew Price, Global Head of Planning Automation, GenesisCare
Read more in FOCUS

In their recent transition to Elekta Monaco treatment planning system, GenesisCare Australia was looking for a scalable, automated, and fully integrated solution to deploy across 37 radiotherapy centers, spread over 4,000 kilometers. In addition to the gain in workflow efficiency brought by Monaco 6 auto-planning capabilities, the integration with MOSAIQ has brought a massive reduction of risk of error in data management. In just a few months, they reorganized their workflow to save more time for their planners to focus on what matters: Personalizing treatment planning and implementing advanced techniques.

Adaptive treatment workflows with Monaco and Versa HD combined

Fast adaptive planning workflows allow you to respond to changes in the patient. Built on the experience of Elekta Unity state-of-the-art MR-Linac, Monaco incorporates a set of tools to help implementing a triggered adaptive workflow. We call it Response Guided Radiation Therapy (RGRT).

Meet your clinical goals with MCO

How do you simultaneously maximize dose to tumor and protect organs at risk? How do you minimize trade-offs between targets and constraints?

The unique Multicriteria Optimization (MCO) approach in Monaco solves these trade-offs for you in real time. No more need for exploration of all possible treatment options. Instead, Monaco finds the plan that best meets your clinical goals directly.

Find out how in this short video.

Personalized proactive support for your Monaco system with IntelliMax"

Elekta IntelliMax® breakthrough in Artificial Intelligence (AI)

  • Award-winning IntelliMax benefits from the latest AI technology
  • Over 75% of Elekta's predictive maintenance activities are raised by AI algorithms with numbers rapidly increasing over time
  • Multiple patents pending on our predictive capabilities

More info

Push the boundaries of your stereotactic capabilities

Reliability, accuracy, and confidence for any SRS and SBRT treatment

Find out how Monaco and Versa HD enable accurate planning and efficient delivery of highly conformal SRS/SBRT treatments.

Sub-millimetric accuracy

Fully integrated HexaPOD™ evo RT positioning system and IntelliBeam functionality provides SRS confidence.

Target more at one time

1 mm virtual leaves and full 40 x 40 cm field size enable fast treatment of multiple and extremely small stereotactic targets.

Treat more patients, faster

Versa HD with HDRS functionality allows you to perform any SRS/SBRT treatment in a standard treatment slot of 15 minutes or less.

High-definition Dynamic Radiosurgery—Discover the Elekta advantage

"Monaco brings various advantages when it comes to stereotactic treatments. For multiple brain metastases, we use Monaco as it takes full advantage of the Agility collimator, in particular the segmentation. For lung, the Monte-Carlo algorithm gives us the confidence that the dose calculation is accurate, even for very small targets."

Professor Frank Lohr, Director, Radiotherapy Service, Department of Oncology, AOU Modena, Policlinico and Director of the residency program in radiation oncology, UniMORE

The ideal partner for proton therapy software

The introduction of proton therapy planning in Monaco 6 expands planning capabilities to deliver a complete software ecosystem with MOSAIQ and Elekta ProKnow, and the ability to manage any photon or proton treatment. With fast GPU based Monte Carlo calculation, Monaco provides proton specific tools for efficient spot placement, automated range shifter optimization, LET evaluation and robust optimization to enable powerful yet simple workflows for proton therapy.

Simple, quality, combined.

Combining decades of innovation in precision radiation medicine with unrivalled experience in treatment planning and adaptive solutions, Elekta proton software is designed for every moment of the patient's journey. In partnering with IBA, Elekta provides a comprehensive solution fully integrated with IBA ProteusONE and ProteusPLUS proton delivery systems.

Improve daily patient treatment with Proton Arc therapy

Dr. Xuanfeng Ding

"We did find a lot of potential clinical benefits for a broader range of clinical indications. All the dosimetry plan qualities are significantly improved with Proton Arc Therapy compared to conventional IMPT."

Dr. Xuanfeng (Leo) Ding, PhD, Lead Medical Physicist, Proton Beam Therapy, William Beaumont Health System, Royal Oak, Michigan, USA

The future of proton therapy. Now for everyone.


One software solution for all

At Elekta, partnerships are key. The team at Willis-Knighton Medical Center, Shreveport, the U.S., are a long-established radiotherapy center utilizing both Elekta linear accelerators and IBA proton therapy machines. Here, they share their experience on our latest solutions and the collaboration between IBA and Elekta.

"Visualization tools, together with the feedback from the constraints sheet, really do help you to do a better optimization as all the information is readily available."

Dr. Kuan Ling Chen
Willis-Knighton Medical Center, Shreveport, USA

Enhanced proton therapy planning

The Proton Therapy Center Czech in Prague, Czech Republic is one of the world's leading providers of proton therapy, having treated over 5,500 patients since they opened in 2012. The center has four treatment rooms, fully equipped with IBA technology, Elekta treatment planning and oncology information management software. Read more about their experience with Monaco proton solution.

"The speed of the GPU based Monte Carlo dose calculation algorithm ensures fast planning, and we obtain excellent quality plans."

Vladimir Vondráček, Head of Medical Physics, Proton Therapy Center Czech, Prague, Czech Republic

Read more in FOCUS

Unlock the power of data to enhance patient care with ProKnow®.


Every day huge amounts of data are created in radiotherapy clinics across the globe. A wealth of insight is contained within these data, but without simple, intuitive solutions, it remains locked away from the experts who need it the most.

By centralizing all your data in a secure web-based repository, Elekta ProKnow® makes it accessible, which opens the door to new insights.

Tools like peer-review and plan evaluation can be used to maintain quality and consistency in clinical practice, and the automatic capabilities, like auto-contouring, ensure a fast and smooth workflow.

Improve standard of care

Elekta ProKnow – Ask the founder

"The first step to creating workflow efficiency is creating data access."

Benjamin E. Nelms, Ph.D., Founder of ProKnow® and Advisor to Elekta

In 2016, Benjamin Nelms co-founded the company ProKnow to bring 'big data' analytics and vital cloud-based capabilities to the field of radiation oncology.

Listen to this audio podcast and hear about the early days of ProKnow, and its recent application in the Elekta Planning Academy and Elekta Plan Challenge.

Download podcast

ProKnow visionary digital teaching tool

RMIT University in Melbourne are delighted by ProKnow as a tool to teach undergraduates and raise standards while building confidence.

Read more

Automate data analysis of long-term health outcomes

Lydia Wilson is a medical physicist and instructor at St. Jude Children's Research Hospital. She explains the importance of longitudinal studies for pediatric cancer patients, and how ProKnow has helped her department organize and improve data collection.

Find out more about Dr. Wilson's experience to automate steps of population data analyses and simplify clinical tasks with ProKnow. Watch her webinar.

Streamline clinical trial management

The Trans-Tasman Radiation Oncology Group (TROG) Cancer Research has been improving the way in which radiotherapy is delivered to cancer patients for almost 30 years.

Working with researchers from Australia, New Zealand and globally, TROG Cancer Research conducts clinical trial research involving radiotherapy to treat many types of cancers such as breast, lung, prostate, skin, head and neck.

More than 14,500 people have volunteered for a TROG Cancer Research trial. To date TROG has conducted more than 100 clinical trials, helping researchers improve cancer treatments that impact on the outcome and quality of life for cancer patients.

TROG Cancer Research works in partnership with more than 70 hospital and cancer treatment centers across Australia and New Zealand.

TROG Cancer Research has been using ProKnow Systems™ for annual plan and contouring challenges since 2017. The challenges are usually aligned with the current trials Approx. 150 plans and above 25 countries are routinely represented.

TROG Cancer Research recently started using Elekta ProKnow across their network. ProKnow allows streamlined processes for data analytics, peer review and overall trial management. There are also a number of technical and clinical focus groups using ProKnow for various projects.

Picture 1 Picture 2 Picture 3

Knowledge sharing and peer-to-peer support at National Particle Therapy Symposium in Australia


"The use of Monaco allowed our comparative planning team to complete a very challenging base of skull IMPT plan. We now have a much better appreciation of the impressive capabilities of Monaco."

Scott Penfold, Lead Medical Physicist, Australian Bragg Centre for Proton Therapy and Research

Improve standard of care for photon and proton therapy

ProKnow provides tool to customize clinical metrics and their objectives into scorecards both for individual patients and across populations. Scorecards help you drive standardization, inspire quality, remove unwanted variation, and justify reimbursement.

The platform also enables comparative effectiveness to help you make data-driven decisions about which techniques, modalities, and protocols work the best for you. The solution supports all planning systems and treatment modalities, including IMRT, VMAT, conventional 3D external beam, protons, robotic radiosurgery, helical arc, and brachytherapy.

Emma Viviers is a treatment planning medical physicist at University of Florida Health Proton Therapy Institute in the Unites States. Her department has been using ProKnow since 2020 with the intent to analyse their historical clinical data. Read more about her interaction with the tool, and with the Elekta ProKnow team.

Maximize operational efficiency with AI based auto-contouring

Introduction to AI program and algorithm

Watch Virgil Willcut, Vice President of Physics and Research at Elekta, speak about the importance of AI in radiotherapy.

Dr. Benjamin Li

"Using AI-based auto-contouring with ProKnow was a very positive experience for me. The generation and review of contours was very fast, and the tool was easy to understand. Having a cloud-based module like ProKnow is also very helpful to efficiently deploy the solution and implement training."

Dr. Benjamin Li, MD, MBA – UCSF, President Executive Director Rayos Contra Cancer

Elekta Care™ Learning
Clinical excellence through focused learning


Introducing Elekta Planning Academy

Delivering the highest possible dose to the target, while sparing healthy tissues and delivering treatment in a time that is reasonable and even comfortable for the patient is what every dosimetrist aims for. Optimizing all those parameters takes skill, practice and devotion which is not always readily available or easy to attain. Elekta Planning Academy, a part of the Elekta Care™ Learning program, supports every treatment planner—from basic to advanced—in their endeavor of designing the best possible dose plan for the case at hand. The Elekta Planning Academy is a suite of planning studies and applicable training videos made specifically for Monaco users.

Expand clinical capabilities
Personalized learning journeys accelerate time-to-proficiency

Learn in the ways most convenient to you
Test your skills in an exciting plan challenge or access training resources anytime and from anywhere through Elekta Care™ Community

Learn from true clinical experts
Peer-to-peer collaboration and dedicated trainers enable clinical excellence

"Monaco Planning Academy helped me a lot. The scorecards available to compare your plan with a population help when evaluating plan quality. This is a very interesting feature and an insightful program, especially for those who start to plan with Monaco. Elekta has an excellent training team, and the content is directed in a good way. I'm very satisfied with it."

Monaco user, Sao Paulo, Brazil

Join the Elekta Planning Academy

As a Monaco user, getting access to the Elekta Planning Academy is a simple three step process:

  1. If you don't already have a user account on, then take a minute to create that account.
  2. Once you have your account set up, you can request access to the Elekta Planning Academy organization.
  3. An Elekta manager will review registrations regularly and accept new members. When you are accepted, you will receive a notification email indicating that you now have immediate access!

Register now

Note: These emails might get automatically filtered to your "Promotions" or “Other” folder where your email server organizes emails from vendors.

Elekta Plan Challenge

This plan challenge complements the Elekta Planning Academy library of training exercises with a unique, once-per-year, international planning event with a special case study and designed in conjunction with a clinical partner.

The Elekta Planning Academy and Plan Challenge are both facilitated by the ProKnow Quality Systems plan study program, a technology which is ideal for largescale studies with participation available 24/7 across the world. There are currently over 10,000 verified users of ProKnow Quality Systems.

Patient case, clinical background

The patient was diagnosed with two left pulmonary adenocarcinomas. SBRT was chosen due to multiple lesions, previous treatment to the contralateral lung, and numerous co-morbidities making other treatment modalities difficult. Without this treatment option the patient would have likely been referred out to another institution.

Plan challenge case 3
Plan challenge case 2
Plan challenge case 1

Four reasons to participate

  1. Participating in the plan challenge provides the unique opportunity to be part of a Monaco planning community.
  2. The planner can take what they have learned from this event , no matter the experience level, and apply it to everyday planning.
  3. This SBRT multiple lesion case provides a challenging yet clinically relevant case in which to exercise your Monaco skills.
  4. By participating, we all learn from each other so we can provide patients with the best care using the most up to date technique.

Ian Quin (left), Director of Service implementation at GenesisCare, Stacy Alvares (center), Clinical Operations Specialist and Jennifer Davis (right), Director of New Technology implementation - Dosimetry at GenesisCare have been closely collaborating with Elekta on the 1st edition of the Elekta Planning Academy.

GC Jen

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