Monaco IMRT is a next-generation planning system that helps to reduce planning time and increase clinical throughput for complex cases with Monaco’s enhanced voxel definitions and advanced sensitivity analysis. Enhanced voxel definition reduces contouring time by automatically taking into account the effects of buildup and heterogeneity. Rapid feedback from sensitivity analysis and decision-support tools quantify the conflicts and trade-offs between dose objectives and OAR constraints, eliminating the trial and error of traditional prescription-based IMRT planning.  Monaco’s advanced biologically-based optimization with optional dose-volume constraints deliver the best possible patient plans, while a robust Monte Carlo dose engine ensures calculation reliability and integrity. Monaco is fully integrated with the CMS Focal platform, providing connectivity and integration with Focal’s advanced fusion, contouring, simulation and plan review capabilities, and represents the state-of-the-art for IMRT planning.