Monaco Installation and Upgrade Instructions

Monaco® Installation and Upgrade Instructions
Monaco 5.51
Elekta, Inc.
Document ID: LIIMON0551
C#98966-EN
Language: English
Copyright statement
© 2019 Elekta, Inc. All rights reserved. Do not make printed or electronic copies of this guide, or
parts of it, without written permission from Elekta, Inc. The information in this guide is for the sole
use of Elekta, Inc. personnel, authorized users and licensees of Elekta, Inc. products, and no other
purpose.
Use of trademarks and trade names statement

The Elekta trademarks, service marks, logos, and trade names that we use in this document are the
registered and unregistered trademarks and trade names of Elekta AB (publ.), its affiliates or a third
party that has licensed its trademarks and trade names to Elekta AB (publ.) or its affiliates. Do not
make copies, show, or use trademarks or trade names without written permission from Elekta, Inc.
an affiliate of Elekta AB (publ.).
Acknowledgement of other trademarks and trade names

Elekta acknowledges the trademarks and trade names of other manufacturers that we use in this
document.
Referenced documents
Elekta does not supply all documents that we refer to in this document with the equipment. Elekta
reserves the right to make the decision on which of the documents it supplies.
Contact information
GLOBAL ELEKTA SOFTWARE SUPPORT

Contact Software Support: https://elekta.com and click Elekta Care
Contact Information: http://www.elekta.com/meta/contact.html
Training Calendar: www.elekta.com/training
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LIIMON0551 / 5.0 / 2019-12-13
Revision History
Revision Date Changes
LIIMON0551 (1.0) 2019/04/25 Updates for the Monaco 5.51 release:
• System requirements
• Validated Systems
• Monaco with Dose Functionality –
Graphics Card Requirements
• Monaco Sim with No Dose
Functionality – Minimum Hardware
Configuration
• Overview
• Upgrading Windows 10 Professional
x64 to branch 1809
• Windows 10 branch 1809 Scripted
Automatic OS Configuration
• Creating the Control Panel shortcut
for Windows 10 branch 1809
• Windows Server 2016 (Branch 1607)
Scripted Automatic OS Configuration
• Configuring the Graphics Card
• Setting up Monaco Shares
Added these sections:
• Location and Sensors
• One Drive
• Setting Windows 10 Components
• Windows Defender – Virus Protection
• Advanced Sharing
• Mouse Setting
• Windows 10 printer and Remote
Desktop Settings (Windows 10 1809
systems only)
• Set a Microsoft PDF Printer –
Windows 10
• Disable Printer Redirection via local
group policy – Windows 10
• HP M652 Printer
• Set a default printer on the Monaco
Workstation
• Accessing Monaco via Remote
Desktop
• Windows Server 2016 (Branch 1607)
Scripted Automatic OS Configuration
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LIIMON0551 / 5.0 / 2019-12-13
LIIMON0551 (2.0) 2019/05/15 Updates for the section:
• Added 2nd note for Windows 10
printer and Remote Desktop Settings
(Windows 10 1809 systems only)
• Set a Microsoft PDF Printer
• Added step 8 in Disable Printer
Redirection via local group policy
HP M652 Printer
LIIMON0551 (3.0) 2019/06/26 Sections updated:
• Revision History
• Added: Monaco with Dose
Functionality – Graphics Card
Requirements section
• Validated Systems
LIIMON0551 (4.0) 2019-08-12 Sections updated for the Monaco 5.51.01

release:
• Workstation Operating System
Configuration
• Using Microsoft Windows media
• NVIDIA Graphics Driver Installation
• Windows 10 version 1903 Scripted
Automatic OS Configuration
• GPU Configuration (GP100 only)
• Changing Security Policy Settings
• LSI MegaRAID Storage Manager Driver
Installation (z820/z840 only)
• Disable GameDVR (Windows 10 only)
• Operating System license Installation
(non-preinstalled systems only)
• Deactivating Automatic Updates
• Disable Data Sent to Microsoft (Server
2016 Only)
• Changing Security Policy Settings
• Install and Configure Server Roles
(2008 R2 only)
• Disable Data Sent to Microsoft (Server
2016 Only)
• Additional Configuration Changes for
Windows Server 2016
• Remote Desktop Users and Set RDP
Color Depth
• Installing NVIDIA Graphics Driver
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• Setting permissions on Global Objects
• Installing MonacoSim
• Upgrading Monaco 5.1X.0X to
Monaco 5.51.01 on Windows 10
• Pointing multiple Monaco systems to
one data location
• Installing Monaco Commissioning
Utility - System Requirements
• Using Microsoft Windows media
5.0 12-13-2019 Replaced Manufacturer address.
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Contents Monaco® Installation and Upgrade Instructions
Contents
Revision History .......................................................................................................................... iii
System requirements .............................................................................................................. 1
Introduction ................................................................................................................................. 1
PC Hardware ................................................................................................................................ 2
Network Requirements ........................................................................................................... 2
Monaco with Dose Functionality – Minimum Hardware Configuration ................................. 2
Monaco with Dose Functionality – Graphics Card Requirements .......................................... 3
Monaco Sim with No Dose Functionality – Minimum Hardware Configuration..................... 4
Monaco Sim with No Dose Functionality – Graphics Card Requirements .............................. 4
Validated Systems ................................................................................................................... 5
Maintenance of Workstations ................................................................................................ 6
Virus Protection ...................................................................................................................... 6
Monaco and MonacoSim Installation prerequisites.................................................................. 7
Overview ...................................................................................................................................... 7
Before you begin ......................................................................................................................... 7
Configuring the Windows Desktop Operating System ................................................................ 8
Upgrading Windows 10 Professional x64 to version 1903 ..................................................... 8
Workstation Operating System Configuration ........................................................................ 9
Windows 10 version 1903 Scripted Automatic OS Configuration ........................................ 10
Creating the Control Panel shortcut for Windows 10 version 1903 ..................................... 13
Deactivating Automatic Updates for Windows 10................................................................ 14
Deactivating Windows Firewall............................................................................................. 14
Deactivating Sleep Mode ...................................................................................................... 15
Setting User Account Control................................................................................................ 15
Setting permissions on Global Objects ................................................................................. 15
Changing Security Policy Settings ......................................................................................... 16
Completing Additional Configuration Changes for Windows 10 .......................................... 17
Operating System license Installation (non-preinstalled systems only) ............................... 19
Windows 10 printer and Remote Desktop Settings (Windows 10 1903 systems
only) ...................................................................................................................................... 20
Windows Server 2016 (Version 1607) Scripted Automatic OS Configuration ........................... 23
Configuring the Windows Server Operating System ................................................................. 24
GPU Configuration (P100 ONLY) ........................................................................................... 24
Removing Internet Explorer Enhanced Security Configuration ............................................ 25
Deactivating Automatic Updates .......................................................................................... 25
Deactivating Windows Firewall............................................................................................. 26
Setting User Account Control................................................................................................ 26
Disable Data Sent to Microsoft (Server 2016 Only) .............................................................. 27
Changing Security Policy Settings ......................................................................................... 27
Install and Configure Server Roles (2008 R2 only) ................................................................ 29
Remote Desktop Users and Set RDP Color Depth ................................................................. 31
Application Privacy................................................................................................................ 33
Data Collection and Preview Builds ...................................................................................... 33
Location and Sensors ............................................................................................................ 33
One Drive .............................................................................................................................. 33
Setting Windows 10 Components......................................................................................... 34
Windows Defender – Virus Protection ................................................................................. 34
Advanced Sharing ................................................................................................................. 34
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Monaco® Installation and Upgrade Instructions Contents
Mouse Settings ..................................................................................................................... 34

Installing NVIDIA Graphics Driver ......................................................................................... 35
Configuring the Graphics Card .............................................................................................. 35
Setting permissions on Global Objects ................................................................................. 36
Installing MonacoSim ............................................................................................................. 37
Upgrading Monaco ................................................................................................................ 39
Uninstalling software ................................................................................................................ 39
Uninstalling Focal/Monaco/Focal 4D.................................................................................... 39
Installing OS updates ................................................................................................................. 40
Upgrading Monaco .................................................................................................................... 40
Upgrading Monaco 5.1X.0X to Monaco 5.51.01 on Windows 10 ......................................... 40
Uninstall Monaco Application .............................................................................................. 40
Installing Monaco Training Data ............................................................................................. 43
Licensing Monaco .................................................................................................................. 43
Configuring your software ...................................................................................................... 45
Changing Published Focal Application to MonacoSim .............................................................. 45
User Authorization setup (Standalone System) ........................................................................ 46
Monaco Standalone User Authorization Setup .................................................................... 46
Creating Users and Permissions in Standalone User Authorization ..................................... 46
Monaco/MOSAIQ Shared Standalone User Authorization Setup ............................................. 48
Pointing multiple Monaco systems to one data location .......................................................... 48
If the Mimer database is not a local installation, you must install the Physics
database manually.Before you start..................................................................................... 48
Designating the location of the User Authorization server ....................................................... 49
Setting up Monaco Shares......................................................................................................... 50
Patient Data Transfers ............................................................................................................... 51
Activate Network Security: LAN Manager Authentication Level .......................................... 51
Setup Data Transfer .............................................................................................................. 52
Allow Other Monaco PCs to Access Your Data ..................................................................... 53
Access Data on Other Monaco PCs ....................................................................................... 53
Updating Monaco workflow settings ........................................................................................ 53
Preferences Tab .................................................................................................................... 53
Graphical Preferences tab .................................................................................................... 53
Tolerance Table tab .............................................................................................................. 54
Rx Sites tab ........................................................................................................................... 54
Monaco Settings – Physics ........................................................................................................ 55
Ports & Materials .................................................................................................................. 55
Laser System ......................................................................................................................... 55
DICOM Machine Mapping .................................................................................................... 57
MLC Dynamic Parameters .................................................................................................... 57
MLC Geometry ...................................................................................................................... 58
MLC Leakage ......................................................................................................................... 58
Micro-MLC Parameters......................................................................................................... 59
Wedge Parameters ............................................................................................................... 59
Stereotactic Cones Parameters ............................................................................................ 59
Treatment Unit Mapping ...................................................................................................... 60
Treatment Unit Storing ......................................................................................................... 61
Adding Treatment Units—Collapsed Cone or Electron Monte Carlo ................................... 61
Adding Treatment Units—Photon Monte Carlo ................................................................... 62
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On A Non-Standalone System: .............................................................................................. 62

On A Standalone System: ...................................................................................................... 63
Check the installation............................................................................................................ 63
DICOM Export ............................................................................................................................ 63
DICOM Preferences............................................................................................................... 63
Configure a DICOM Printer for DRR Export ............................................................................... 65
DICOM Scanner.......................................................................................................................... 66
Installing Monaco Commissioning Utility ............................................................................... 67
System Requirements ................................................................................................................ 67
Installing and Licensing Monaco Commissioning Utility............................................................ 67
Navigating to the MCU License Editor .................................................................................. 68
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Monaco® Installation and Upgrade Instructions Contents
Figures
Figure 1: Remote Desktop Connection dialog box ......................................................................... 22
Figure 2: Remote Desktop Connection dialog box – Local Resources tab ..................................... 22
Figure 3: Edit License dialog box .................................................................................................... 44
Figure 4: Use Windows Explorer to share Laser System folders .................................................... 56
Figure 5: DICOM Settings dialog box .............................................................................................. 63
Figure 6: DICOM Settings window.................................................................................................. 65
Figure 7: Monaco test window - Correct........................................................................................ 65
Figure 8: Monaco test window - Incorrect ..................................................................................... 66
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Monaco® Installation and Upgrade Instructions System requirements
System requirements
Introduction
Thank you for your purchase of Monaco 5.51. You may contact Elekta Software
Customer Support for assistance at any time during or after the upgrade.
This upgrade package contains the following media:
• Monaco Release DVD (REF 89945-nnnnn)

NOTE: nnnnn is the release/patch number such as 55101, 55100, as
necessary.
• Monaco Operating System Update/Utilities DVD (REF C#89946-nnnnn)
• Monaco Training Data DVD (REF 89820-nnnnn)
• Windows 10 Professional x64 Version 1903 DVD (REF C#89866)
• Windows 10 Professional Upgrade DVD (C#89865) – For upgrades from
Windows 10 versions 1511/1703/1803/1809 to Version 1903
Monaco has been tested on:
• Windows 7 (SP1) 64-bit Professional

• Windows 8.1 64-bit Professional
• Windows 10 version 1903 (build 18362)
• Windows Server 2008 R2 (SP1) Standard and Enterprise
• Windows Server 2012 R2 Standard
• Windows Server 2016 Standard version 1607 (Build 14393)
Elekta does not ensure or support the correct operations of Monaco
software for any other operating system.
Monaco is extensively tested on specific hardware platforms. Do not
CAUTION install the Monaco software on untested hardware platforms. To
determine appropriate hardware platforms, contact Elekta.
NOTE: Windows 10 versions below 1903 are NOT supported on Monaco

5.51.01.
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System requirements Monaco® Installation and Upgrade Instructions
PC Hardware
Network Requirements
Before you install Monaco, verify that your PC is correctly configured and
connected to your network. In addition, your PC must have a static IP address
assigned to it.
Monaco with Dose Functionality – Minimum Hardware Configuration
You can only upgrade Monaco with dose functionality on validated

systems provided by Elekta.
CAUTION
Hardware Recommended Requirements
Description Minimum Requirements
System Processor HP Model Z800 w/Dual 6-Core HP Model Z8 G4 w/Dual 14-
Unit (SPU) Processors Core Processors
Processor Chips (2) 2.66 GHz Xeon w/12MB 2.60 GHz
memory
CPU RAM 96 GB (128 GB for z820 or 128 GB
later)
Hard Drive 300 GB 1 TB
CD/DVD Drive 16x 16x
Keyboard USB Standard USB Standard
Mouse USB Standard USB Standard
Monitor 24-inch LED 24-inch LED
Graphics NVIDIA Quadro 600 PCIe* NVIDIA Quadro P2000 PCIe or
NVIDIA Quadro P2200 PCIe
*P2000 or P2200 if Adapt Anatomy is required.
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Monaco with Dose Functionality – Graphics Card Requirements

To increase the speed of the Collapsed Cone dose calculation algorithm, use a computing
GPU. This is a computation only graphics card for general use.
NOTE: It is strongly recommended that you use a computing GPU when ABAS and
Monaco operate on the same system.
Only use NVIDIA cards with ECC memory and support for CUDA 8.0.
The supported graphics cards for Collapsed Cone are:
• Tesla K20 (Z820, Z840, Gen8 V1 & V2)

• Tesla K40 (Z840/DL380 Gen9 V3 & V4)
• Tesla P100 (Server only DL380 Gen9 CPU V4)
• Quadro GP100 (Workstation only Z840 CPU V4)
ECC and TCC must both be enabled for GPUMCD. The supported graphics cards for
GPUMCD are:
• Tesla P100 (Server only DL380 Gen9 or later CPU V4) – Requires 2 for
Elekta Unity
• Quadro GP100 (Workstation only Z840 or later CPU V4) – Requires 2 for
Elekta Unity
The supported graphics cards for Adapt Anatomy are:
• Tesla K20 (Z820, Z840, G8 V1 & V2)

• Tesla K40 (Z840/DL380 Gen9 V3 & V4)
• Tesla P100 (Server only DL380 Gen9 CPU V4 and DL380 Gen10 6132)
• Quadro GP100 (Workstation only Z840 CPU V4 and Z8 G4 6132)
• Quadro P2000 (Z820, Z840, Z4 G4, Z8 G4, DL380 Gen8, Gen9, P2200,
and Gen10 6132)
CUDA 8.0 is supported by the NVIDIA Tesla display driver version 307.45 and newer.
For installation, contact your Monaco service partner.

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Monaco Sim with No Dose Functionality – Minimum Hardware

Configuration
You can install MonacoSim on computer hardware that you provide.
It must meet the minimum hardware and operating system
CAUTION requirements.
Hardware Recommended Requirements
System Processor Intel-based Pentium Dual-Core Intel-based Xeon 4-Core
Unit (SPU)
Processor Chips (2) 2.70 GHz 3 GHz
CPU RAM 8 GB 16 GB
Hard Drive 250 GB 512 GB
CD/DVD Drive 16x 16x
Keyboard USB Standard USB Standard
Mouse USB Standard USB Standard
Monitor 24-inch LED 24-inch LED
Graphics NVIDIA Quadro 600 PCIe* NVIDIA Quadro P2000 PCIe or
NVIDIA Quadro P2200 PCIe
*P2000 or P2200 if Adapt Anatomy is required.
Monaco Sim with No Dose Functionality – Graphics Card

Requirements
The supported graphics cards for Adapt Anatomy are:
• Tesla K20 (Z820, Z840, G8 V1 & V2)

• Tesla K40 (Z840/DL380 Gen9 V3 & V4)
• Tesla P100 (Server only DL380 Gen9 CPU V4 and DL380 Gen10 6132)
• Quadro GP100 (Workstation only Z840 CPU V4 and Z8G4 6132)
• Quadro P2000 (Z820, Z840, Z4 G4, Z8 G4, DL380 Gen8, Gen9, Gen10 6132,
P2200, and GV100)
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Validated Systems
Elekta validated Monaco on the following hardware and software systems:
Hardware
Component Operating System End of Life (EOL)
Workstations
HP G4 Windows 10 Pro 64-bit TBD
HP Z440 Windows 10 Pro 64-bit TBD
HP Model Z800 (Dual 6-Core) Windows 7 Pro 64-bit 1/31/2019
HP Z820 (Dual 8-core) Windows 7 Pro 64-bit 3/31/2020
HP Z820 (Dual 8-core) Windows 8.1 Pro 64-bit 3/31/2020
HP Z820 (Dual 12-core) Windows 7 Pro 64-bit 9/30/2020
HP Z820 (Dual 12-core) Windows 8.1 Pro 64-bit 9/30/2020
HP Z840 (Dual 14-core V3) Windows 7 Pro 64-bit 11/30/2021
HP Z840 (Dual 14-core V3) Windows 8.1 Pro 64-bit 11/30/2021
HP Z840 (Dual 14-core V4) Windows 10 Pro 64-bit 7/31/2023
HP Z8 G4 (Dual 14-core 6132) Windows 10 Pro 64-bit TBD
Servers
DL380 G8 (Dual 8-core) Windows 2008 R2 64-bit 3/31/2020
DL380 G8 (Dual 12-core) Windows 2008 R2 64-bit 9/30/2020
DL380 G9 (Dual 14-core V3) Windows 2012 R2 64-bit Ent. 11/30/2021
DL380 G9 (Dual 14-core V4) Windows 2012 R2 64-bit 12/31/2023
DL380 G10 (Dual 14-core 6132) Windows 2012 R2 64-bit TBD
DL380 G10 (Dual 14-core 6132) Windows 2016 64-bit TBD
Elekta Data Center VM 6.0 Windows 2012 R2 64-bit TBD
Microsoft will no longer support the Windows 7 and 2008 R2 operating systems
after January 14, 2020.
Elekta cannot guarantee performance of any system operating on platforms other than
what has been validated.

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Table Description
• Component lists the systems the software was validated on.
• Operating System lists the operating system of the validated system.
• Hardware End of Life (EOL) lists the date Elekta will no longer support the
hardware system. Elekta will no longer install or validate software on the system
after this date.
Maintenance of Workstations
For software, contact Customer Support.
If you purchased hardware from Elekta, contact Customer Support.
If you are having hardware issues, and you did not purchase your equipment from Elekta,
call the business where you purchased the equipment.
Virus Protection
This software does not come with any virus protection software installed.
Users should not load other software on the same PC that they are using to run Monaco to
avoid interference between the programs. It is the user’s responsibility to validate the
system after loading virus protection or other software on the same PC to ensure the
product remains clinically safe and effective.
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MonacoSim Installation and Upgrade Instructions Installation prerequisites
Monaco and MonacoSim Installation

prerequisites
Overview
You can install Monaco on the following operating systems:
• Windows 7 (SP1) 64-bit Professional
• Windows 8.1 64-bit Professional
• Windows 10 Professional 64-bit version 1903 (build 18362)
• Windows Server 2008 R2 (SP1) Standard and Enterprise
• Windows Server 2012 R2 Standard
• Windows Server 2016 Standard version 1607 (Build 14393)
Before you begin

You must be logged in as a user with administrator privileges. Elekta requires a
user with administrative privileges on the local machine or domain to perform the
upgrade and configuration.
Elekta strongly recommends that you temporarily disable any virus protection
software during the installation and configuration processes. Virus protection
software can interfere with the performance of the installation. It can cause the
installation and/or configuration to fail. Once you complete the installation
process and configure the software, you can enable the virus protection.
NOTE: Monaco does not include a procedure to automatically back up data.

You must do this manually.
Certain Novell networks need special administrative privileges to upgrade

Monaco. Please contact your IS department or Elekta Software Customer
Support if you are unsure about this requirement.

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Installation prerequisites MonacoSim Installation and Upgrade Instructions
Configuring the Windows Desktop Operating System

This section only applies to Windows 7, Windows 8.1, and Windows 10. For
Server 2008 R2/2012 R2/2016, go to the Configuring the Windows Server
Operating System.
Before you install Monaco, the desktop operating system requires the following
configuration changes.
Before you start, back-up all system data and close all open applications.
Upgrading Windows 10 Professional x64 to version 1903

NOTE: The only version of Window 10 supported in Monaco 5.51.01, is
Windows 10 Professional x64 version 1903. You must do a scratch
install for versions higher than version 1903 and upgrade lower
versions.
1. To see which version of Windows 10 is installed, do these steps:

a. Login to the system as an administrative user. You cannot use the
default Windows administrator user account to upgrade the system.
b. Right-click the Start menu and select Command Prompt or
Windows PowerShell.
c. Enter the systeminfo.
d. From the output of the command, if the OS Version is less
than18362, upgrade the OS. Go to step 2. If the OS Version is higher
than18362, go to section Using Microsoft Windows Media.
Below is an example output and the version number is in bold type
face:
Example: OS Version: 10.0.10586 N/A Build 10586.
In the above example, the OS Version is 10586 which is less than
18362, so you can upgrade the OS.
2. Unplug the network cable from the system and make a note of the port. If
you do not unplug the network cable during the upgrade process, Windows
may upgrade to an untested version of the operating system.
3. Insert the Windows 10 Professional Upgrade Disc, P/N C#89865 into the
disc drive.
4. Use Windows explorer to browse the optical drive and double-click the
Setup.exe file.
5. Select Yes to the User Account Control message.
6. At the Get Important updates, select Not Right Now and ensure that I want
to help make this installation of Windows better is not selected.
7. Select Next.
8. Accept the End User License Agreement.
9. At the What needs your attention prompt, click OK.
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10. On the Ready to Install screen, click Install. The machine can reboot
multiple times and can take 30 minutes or more for the upgrade to complete.
11. On the Welcome screen, click Next.
12. On the Choose privacy settings for your device screen, change all settings to
Off and click Accept.
13. On the Meet Cortana window, click Not now.
14. On the New Apps… window, click Next.
15. Login to the system as an administrative user.
16. Right-click the Start menu and select Windows PowerShell.
17. Enter the command “systeminfo” and verify that this information displays:
OS Version: 10.0.18362 N/A Build 18362
18. Plug in the network cable back into the correct port.
19. Go to the Configuring your software section.
NOTE: Do not skip this step. There are additional configuration settings
required for Windows 10 version 1903.
Workstation Operating System Configuration

For Windows 10 z840’s and z8 G4’s only, perform the following steps:
1. Login to the OS.

2. Right-click on the Start menu. and
3. Select Run.
4. Type “cmd” to start Command Prompt.
5. Enter “systeminfo”.
Verify that the OS Version states “10.0.18362 Build 18362” before going to
the next section.
If the build number is higher than 18362, complete section Using Microsoft
Windows media in conjunction with C#89866 (Windows 10 media version
1903), to do a scratch install of Windows 10.
If the build number is lower than 18362, complete section Upgrading

Windows 10 Professional x64 to version 1903.
Using Microsoft Windows media

1. With the network cable removed from the system, boot from the Windows media
disc (C#89866 for Windows 10 1903) and follow the prompts to complete the
installation.
2. When prompted for a version of Windows 10, choose Windows 10 Pro for
Workstations.
3. When prompted for “Who is going to use this PC?”, enter Elekta.

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4. Enter Focus1.1 in the password field.

5. When prompted for choosing 3 security questions, choose the following:
a. What was your first pet’s name?
b. Answer: ElektaD0G!
c. What’s the name of the city where you were born?
d. Answer: St. L0uis
e. What was your childhood nickname?
f. Answer: C0mputerizedMedicalSystems
6. At “Make Cortana Your Personal Assistant?”, select Decline.
7. At “Do more across devices with Activity History”, select No.
8. Swipe all the privacy settings to the left-hand side value and click Accept.
9. Use the Monaco OS update DVD (P/N C#89946-55101) to install any missing
drivers.
NVIDIA Graphics Driver Installation

1. Insert the Monaco OS Update disk (P/N C#89946-55101) into the optical
drive.
2. Close any autorun menus that show.
3. Navigate to the NVIDIA\<windows version> folder.
4. Double-click the executable file (.exe).
5. Complete the clean installation of the NVIDIA driver.
6. If necessary, reboot the system.
Windows 10 version 1903 Scripted Automatic OS Configuration

NOTE: For Windows 10 Version 1903, the majority of the OS Configuration
has been scripted. If any failures are encountered in the output of the
script, the manual OS step(s) must be completed.
1. Insert the Monaco OS Update disc (P/N C#89946-nnnnn) into the optical
drive.
necessary.
2. Right-click the Start menu.

3. Click Run.
4. Enter ms-settings:windowsdefender.
5. Click Virus & Threat protection.
6. Select Manage Settings.
7. Disable Tamper Protection.
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8. Using Windows Explorer, browse to the

ConfigurationTool\Windows10_1903 directory on the Monaco OS updates
DVD.
9. Double-click Win10ConfigTool.exe, click Yes to the UAC message.
10. Click Enter to continue. You might have to reboot the PC.
11. Double-click the Win10TestTool.exe and click Yes to the UAC message.
12. At the completion of the script, a dialog will be displayed listing the settings
that were configured along with the PASS/FAIL status and a message about
viewing the logfile.
13. If there are failures, enter Y to view the logfile and proceed to the appropriate
section in the Workstation Operating System Configuration to manually
configure the settings. If there are no failures, enter N and press Enter at the
Press Enter to continue prompt.
NOTE: The following steps could not be automated and need to be
completed manually.
a. Click the Control Panel icon on the desktop.

b. Select Administrative Tools and double-click Local Security
Policy.
c. Expand Local Policies and select User Rights Assignment.
d. Double-click Create Global Objects.
e. Add the group, Users (may have to select object types and ensure
Groups is checked) and select OK. Close the Security Policy dialog
box.
f. Select All Control Panel items to return to the main screen of the
Control Panel.
g. Select Network and Sharing Center followed by Change
advanced sharing settings.
h. Select the Down Arrow next to All networks to expand the options.
i. Set the following:
i. Public Folder Sharing:
a) Turn off Public Folder sharing.
ii. File Sharing Connections:
a) Enable file sharing for devices that use 40 or 56-bit
encryption.
iii. Password protected sharing:
a) Turn off password protected sharing.
j. Click Save Changes and click All Control Panel items to return to
the Control Panel main screen.
k. Select Security and Maintenance.
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l. Click Change Security and Maintenance Settings.

m. Deselect the Network Firewall box.
n. Click OK.
o. Close the Control Panel window.
p. Proceed to Installing OS updates section.
GPU Configuration (GP100 only)

If PowerShell is used instead of the administrative command prompt, the output
of the command will not be correct
1. Open an administrative command prompt.

Search “cmd.exe”
Right-click on Run as Administrator and change the directory:
“CD C:\Program Files\NVIDIA Corporation\NVSM”
2. Enter the following command (on 1 line):
NOTE: There are 2 dashes before “Query” and “Format” in the
following command.
nvidia-smi.exe --query-
gpu=name,index,ecc.mode.current,ecc.mode.pending,
driver_model.current,driver_model.pending --
format=csv
This is an example of the command result:

name, index, ecc.mode.current, ecc.mode.pending, driver_model.current,
driver_model.pending
Quadro GP100, 0, Enabled, Enabled, WDDM, WDDM
Quadro P620, 1, [Not Supported], [Not Supported], WDDM, WDDM
Quadro GP100, 2, Enabled, Enabled, WDDM, WDDM
Note that driver_model.current and driver_model.pending are incorrectly
set as “WDDM” for GPU 0 and GPU 2.
3. For P100 and GP100 cards: Examine the results and make sure these settings
are shown: ecc.mode.current = Enabled, ecc.mode.pending = Enabled.
4. If any of the settings are different, enter the following command for each
incorrect GPU:
“C:\Program Files\NVIDIA
Corporation\NVSMI>nvidia-smi -i <GPU index> -e 1”
Note the GPU index is listed in the result from step 3
5. (For GP100 cards only) Make sure the following settings for each incorrect
GPU:
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driver_model.current = TCC, driver_model.pending

= TCC
6. If this setting is different, enter the following command:
C:\Program Files\NVIDIA Corporation\NVSMI>nvidia-
smi -i <GPU index> -dm 1
Creating the Control Panel shortcut for Windows 10 version 1903
NOTE: The Control Panel selection is not on the WinX menu for Windows 10
version 1903. It was replaced with the Settings menu. Follow the steps
below to make a desktop shortcut to the Control Panel.
1. Right-click the desktop and select New then Shortcut from the shortcut
menu.
2. Click Browse and go to C:\Windows\System32.
3. Select Control.exe.
4. Click Next.
5. Set the shortcut name to Control Panel.
6. Click Finish.
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Deactivating Automatic Updates for Windows 10

Skip this step for MonacoSim installation.
1. Right-click the Start menu and select Run.

2. Enter gpedit.msc and select OK.
3. Select Yes to the User Account Control message if prompted.
4. Expand Local Computer Policy > Computer Configuration >
Administrative Templates > Windows Components then click Windows
Update.
5. Double-click Configure Automatic Updates.
6. Disable the policy and select OK.
7. Select OK.
8. Double-click Allow non-administrators to receive update notifications.
10. Double-click Turn on recommended updates via Automatic Updates.
12. Double-click Do not connect to any Windows Update Internet Locations.
13. Enable this policy and select OK.
14. Close the Group Policy dialog box.
15. Right-click the Start menu and select System.
16. Select System Info > Advanced System Settings and click the Hardware
tab.
17. Select Device Installation Settings.
18. Click No then select Save Changes next to the “Do you want to
automatically download manufacturer’s apps and custom icons available for
your devices?” option.
19. Close all open windows.
Deactivating Windows Firewall

Find the correct step that relates to the operating system in the clinic then follow
those steps.
1. For Windows 10 X64, double-click Control Panel.

2. Change the View by to Small icons.
3. Double-click Windows Firewall.
4. Deactivate the firewall.
5. Click Control Panel Home to return to the Control Panel.
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Deactivating Sleep Mode

1. Double-click Power Options.
2. Click Change when the computer sleeps.
3. Set Put the computer to sleep to Never.
4. Click Save Changes.
5. Click Control Panel Home to return to the Control Panel.
Setting User Account Control

1. Click the User Accounts icon.
2. Click Change User Account Control Settings.
3. For Windows 7 X64, drag the slider bar to Never notify me when:.
4. For Windows 8.1/10 X64, drag the slider bar to Notify me only when apps
try to make changes to my computer (do not dim my desktop).
5. Click OK.
6. Click Yes to confirm.
7. Restart the computer.
Setting permissions on Global Objects

1. Open the Control Panel.
2. Select Administrative Tools.
3. Double-click Local Security Policy.
4. Expand the Local Policies option.
5. Click User Rights Management.
6. Double-click Create Global Objects.
7. Click Add User or Group.
8. Add the group Users. It is possible you have to select Object Types and
ensure Groups is checked.
9. Apply the changes.
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Changing Security Policy Settings

1. In the Local Security Policy dialog box, open Account Policy > Password
Policy.
2. Double-click Enforce password history.
3. Enter 24 and click OK.
4. Select Maximum password age.
6. Select Minimum password length.
8. Double-click Password must meet complexity requirements.
9. Select Enabled and click OK.
10. In the Local security policy dialog box, open the Local Policies and select
Security Options.
11. For Monaco Dose calculation systems (Windows 10 version 1903 or later),
double-click Interactive logon: Do not display last user name (or Don’t
display last signed in for Windows 10 version 1709 or later).
13. Select Interactive logon: Prompt user to change password before
expiration.
15. Close the Local Security Policy dialog box.
LSI MegaRAID Storage Manager Driver Installation (z820/z840 only)

1. Insert the Monaco OS Update disk (P/N C#89946-55101) into the optical
drive and
2. Close any autorun menus that open.
3. For the z820 and z840, navigate to the: z840\<OS
version>\MegaRAID_Storage directory.
4. Double click the .exe and complete the installation of the LSI MegaRAID
driver without specifying the LDAP configuration details. If an error pops
up during the installation stating that “The installation of vcredist_2012_x86
appears to have failed….”, click Yes to continue the installation.
5. Double click AllowGameDVR and change the value to 0.

6. Select OK.
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Disable GameDVR (Windows 10 only)

1. Right-click on the windows Start menu and select Run.
2. Enter “regedit” followed by OK.
3. Click Yes on the UAC message.
4. Browse to this path:
HKEY_LOCAL_MACHINE\SOFTWARE\Microsoft\PolicyManager\default\Ap
plicationManagement\AllowGameDVR
5. Double click AllowGameDVR and change the value to 0.
6. Select OK.
Disable Data sent to Microsoft (Windows 10 only):

HKEY_LOCAL_MACHINE\SOFTWARE\Policies\Microsoft\Windows\Datacol
lection.
2. Right Click on Datacollection.
3. Select New > DWORD (32-bit) Value.
4. Name the value “AllowTelemetry” and set the value to 0.
5. Select OK and close the Registry Editor.
6. Right-click on the Start menu and select Run.
7. Enter services.msc and click OK.
8. Double-click on Connected User Experiences and Telemetry Properties.
9. Set the Startup type: to Disabled.
10. Select OK.
11. Close the registry editor dialog.
Completing Additional Configuration Changes for Windows 10
Disable GameDVR (Windows 10 only):

2. Enter regedit followed by OK.
HKEY_LOCAL_MACHINE\SOFTWARE\Microsoft\PolicyManager\
default\ApplicationManagement\AllowGameDVR
5. Double-click Value and change the Value Data from 1 to 0.
6. Select OK.
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Application Privacy
Administrative Templates > Windows Components and select App Privacy.
5. For every item listed except “Let Windows apps access trusted devices” and
“Let Windows apps run in the background”, complete these steps:
a. Double-click the setting and enable it.
b. Select Force Deny.
c. Click OK.
Data Collection and Preview Builds

Administrative Templates > Windows Components and select Data
Collection and Preview Builds.
2. Double-click the Do not show feedback notifications.
3. Select Enabled.
4. Click OK.
Location and Sensors

Administrative Templates > Windows Components and select Location
and Sensors.
2. Double-click Turn off location.
3. Select Enabled.
4. Click OK.
One Drive
Administrative Templates > Windows Components and select OneDrive.
2. Double-click Prevent the usage of OneDrive for file storage.
3. Select Enabled.
4. Click OK.
Setting Windows 10 Components

Administrative Templates > Windows Components and select Search.
2. Double-click Allow Cortana.
3. Select Disabled.
4. Click OK.
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5. Close the Local Group Policy Editor dialog.
Windows Defender – Virus Protection

1. Right-click the Start menu and select Settings.
2. Click Update > Security > Windows Defender.
3. Select Open Windows Defender Security Center.
4. Select Virus & threat protection followed by Virus & threat protection
settings.
5. Turn off the Cloud-based Protection and Automatic sample submission.
6. Select Yes to the User Account Control messages.
7. Close the Settings dialog box.
Advanced Sharing
1. Select Control Panel.
2. Select Network and Sharing Center.
3. Select Change advanced sharing.
4. Click the drop-down arrow next to All networks.
5. Set the following:
• Public Folder Sharing
o Turn off Public Folder sharing
• File Sharing Connections:
o Enable file sharing for devices that use 40 or 56-bit
encryption
• Password protected sharing:
o Turn off password protected sharing.
6. Click Save changed and close all open windows.
Mouse Settings
1. Click Start > Settings > Devices > Mouse.
2. Deselect the Turn Scroll inactive windows when I hover over them option.
Operating System license Installation (non-preinstalled systems only)
Windows 7 X64
1. Click Start, right click on Computer and select Properties.
2. At the bottom of the dialog window underneath Windows activation, select
Change product key.
3. Enter the product key and complete the windows Activation wizard.
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Windows 8.1 X64:

1. Right click on the Start menu and select system.
2. Under Windows activation, select view details in Windows activation.
3. Select Activate with a new key.
4. Enter the product key and complete the Windows Activation Wizard.
Windows 10 X64
1. Right click on the Start menu and select system.
2. Select Change Product Key or activate Windows.
3. Enter the product key or select Activate and complete the Windows
Activation Wizard.
Windows 10 printer and Remote Desktop Settings (Windows 10 1903

systems only)
NOTE: Utilizing Microsoft OneNote in Monaco for printouts is not supported.
Microsoft OneNote causes Monaco reports to shift data which makes
some fields unreadable.
For Windows 10 systems, make sure there is a default printer set for
each user account. This is for local and domain accounts.
If there is no default printer is included, set it to Microsoft PDF Printer.
Update these settings for each Windows 10 system that uses RDP (Remote
Desktop Protocol) to access a Windows 10 Monaco workstation. The next 2
sections, Error! Reference source not found. and Disable Printer Redirection
via local group policy, use the Windows 10 operating system.
Set a Microsoft PDF Printer – Windows 10

Only use this option if there is not a physical printer available.
1. Go to Settings > Devices > Printers & Scanners.

2. Select Microsoft Print to PDF.
3. Click Open queue.
4. Click Printer when the window opens.
5. Click Set As Default Printer.
6. Close Microsoft Print to PDF window then the Printers & scanners widow.
Disable Printer Redirection via local group policy – Windows 10

1. Right-click the Start menu.
2. Click Run.
3. Type gpedit.msc and select OK.
4. Select Yes to the User Account Control message if necessary.
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Administrative Templates > Windows Components > Remote Desktop
Services > Remote Desktop Session Host.
6. Select Printer Redirection.
7. Double-click Do not allow client printer redirection.
8. Select Enable.
9. Click OK.
HP M652 Printer
1. Insert the driver disk for the M652 Printer.
2. Browse to the disc and click on Setup.exe, if autorun does not start.
3. Click on “I’d rather set up using the CD”.
4. Click Continue.
5. Accept the End User License Agreement.
6. Click Next.
7. Select Wired Network.
8. Click Next.
9. Select the M652 printer and click Next.
10. Follow prompts to complete installation.
Set a default printer on the Monaco Workstation

1. On the Control Panel, select Devices and Printers.
2. Right-click on the printer to set as the default and select Set as default
printer. If no printers exist, contact Elekta Support.
3. Close the Control Panel dialog.
Accessing Monaco via Remote Desktop

NOTE: The following settings need to be made to each Windows 10 system
that uses RDP (Remote Desktop Protocol) to access a Windows 10
Monaco workstation.
1. On the Remote Desktop Connection dialog, click Show Options.
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Figure 1: Remote Desktop Connection dialog box

2. Select the Local Resources tab.
Figure 2: Remote Desktop Connection dialog box – Local Resources tab

3. Deselect Printers.
4. Connect to the Monaco workstation.
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Windows Server 2016 (Version 1607) Scripted Automatic OS

Configuration
NOTE: On Windows Server 2016 Version 1607, most of the OS is scripted.

If any failures are encountered in the output of either script, the
manual version of the step must be completed.
1. Insert the Monaco OS Update disc, P/N C#89946-55101 into the optical drive.
2. Use Windows Explorer to browse to the ConfigurationTool\Server2016_1607
directory.
3. Double-click Srv2016ConfigTool.exe.
4. Click Yes to the User Account Control message, if necessary.
5. Click Enter on the At the Configuration Completed dialog box. The system
will reboot.
6. Login to the system as an administrative user.
7. Use Windows Explorer to browse to the ConfigurationTool\Server2016_1607
directory on the Monaco OS updates DVD.
8. Double-click the Srv2016TestTool.exe.
9. Click Yes if prompted with User Account Control message.
10. When the script is complete, a dialog box shows. It lists the settings that were
configured, the PASS/FAIL status, and a message to view the logfile.
11. If there are failures, enter Y to view the logfile and go to the correct section in the
Workstation Operating System Configuration to manually configure the settings.
If there are no failures, enter N, and press enter at the Press Enter to continue.
NOTE: The following steps could not be automated and will need to be
completed manually:
12. Right-click the Start menu and select Control Panel.

13. Select Administrative Tools>Local Security Policy.
14. Expand Local Policies.
15. Select User Rights Assignment.
17. Click the Add User or Group….
18. Select Object Types.
19. Make sure Groups is selected and click OK.
20. Type Power Users in the Enter the object to select box.
21. Select OK twice.
22. Close all windows.
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Configuring the Windows Server Operating System

This section only applies to Server 2008 R2/2012 R2 and Server 2016. For
Windows 7, Windows 8.1, and Windows 10 go to the Configuring the Windows
Desktop Operating System section.
Before you install Monaco, the Server operating system requires the following
configuration changes.
Before you start, back-up all system data and close all open applications.
GPU Configuration (P100 ONLY)

NOTE: If PowerShell is used instead of the administrative command
prompt, the output of the command will NOT be correct.
1. Open an administrative command prompt (Search “cmd.exe” and

right click for “Run as Administrator”) and change directory: “CD
C:\Program Files\NVIDIA Corporation\NVSMI
2. Enter the following command (all on one line):
NOTE: THERE ARE TWO DASHES IN FRONT OF QUERY AND
FORMAT IN THE COMMAND BELOW.
nvidia-smi.exe --query-
gpu=name,index,ecc.mode.current,ecc.mode.pending,
driver_model.current,driver_model.pending --format=csv
The output should resemble this example:

name, index, ecc.mode.current, ecc.mode.pending, driver_model.current,
driver_model.pending
Tesla P100, 0, Enabled, Enabled, TCC, TCC
Quadro P620, 1, [Not Supported], [Not Supported], WDDM, WDDM
Tesla P100, 2, Enabled, Enabled, TCC, TCC
Note that driver_model.current and driver_model.pending are
incorrectly set as “WDDM” for GPU 0 and GPU 2.
3. For the P100 card: Examine the results and ensure that “Enabled,
Enabled” is listed.
4. If either is set differently, enter the following command for each
incorrect GPU:
“C:\Program Files\NVIDIA Corporation\NVSMI>nvidia-smi -i
<GPU index> -e 1”
Note the GPU index is listed in the output from step 2.
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Removing Internet Explorer Enhanced Security Configuration

1. Log in to the system as an administrator.
2. For Server 2008 R2:
a. Click Start > Administrative Tools > Server Manager and select
Configure IE ESC (in the Security Information sections).
b. Select Off for both administrators and users.
OR
For Server 2012 R2:
a. Select the Server Manager icon (next to the Start menu).
b. Select Local Server on the left side of the dialog.
c. Select IE Enhanced Security Configuration.
d. Turn off IE Enhanced Security Configuration for both
administrators and users.
3. Click OK.
Deactivating Automatic Updates
2008 R2
1. Click Start > Control Panel for 2008 R2.
2. Double-click Windows Update.
3. Disable Automatic Updates.
Server 2012 R2
1. Right-click on the Windows start icon and select Control Panel.
2. Double-click Windows Update.
3. Disable Automatic Updates.
For Server 2016:

1. Right-click the Windows start menu and select Run.
3. Go to Local Computer Policy > Computer Configuration > Administrative
Templates > Windows Components and click Windows Update.
4. Double-click Configure Automatic Updates.
6. Double-click Allow non-administrators to receive update notifications.
8. Double-click on Turn on recommended updates via Automatic Updates.
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10. Double-click Do Not Connect to any Windows Update Internet

Locations.
11. Enable this policy and select OK.
Deactivating Windows Firewall
For Server 2008 R2:

1. Click Start > Control Panel.
2. Set the View By: to small icons.
4. Disable the firewall setting.
For Server 2012R2/2016:

1. Right-click on the Start button and select Control Panel.
2. Set the View By: to small icons.
4. Disable the firewall setting.
Setting User Account Control
For Server 2008 R2

2. Double-click User Accounts.
4. Drag the slider to Never notify me when.
5. Click OK.
6. Click Yes.
7. Restart the computer so the changes take effect.
Server 2012 R2
2. Double-click User Accounts.
4. Drag the slider to Notify me only when apps try to make changes to my
computer (do not dim my desktop).
5. Click OK.
6. Restart the computer so the changes take effect.
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Disable Data Sent to Microsoft (Server 2016 Only)

1. Browse to following path:
HKEY_LOCAL_MACHINE\SOFTWARE\Policies\Microsoft\Wind
ows\Datacollection
2. Right-click on Datacollection and select New > DWORD (32-bit) Value.
3. Name the value “AllowTelemetry” and set the value to 0.
5. Right-click the Start button .
6. Select Run.
7. Type services.msc and click OK.
9. Set the Startup type: to disabled.
10. Select OK.
11. Close the registry editor dialog box.
Disable Desktop Composition (2008 R2 only)

1. Click Start.
2. Click on Computer, then Properties.
3. Select Advanced System Settings.
4. Select Settings under Performance.
5. Uncheck Enable Desktop Composition.
6. Select OK.
7. Select OK.
Changing Security Policy Settings

1. For Server 2008 R2 systems: select Start->Control Panel.
2. For Server 2012 R2/2016 systems: r-Right-click on the Windows Start
button and select Control Panel.
3. Select Administrative Tools > Local Security Policy.
4. In the Local Security Policy dialog box, open Account Policy > Password
Policy.
5. Double-click Enforce password history.
7. Select Maximum password age.
9. Select Minimum password length.
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11. Double-click Password must meet complexity requirements.

13. In the Local security policy dialog box, open the Local Policies and select
Security Options.
14. For Monaco Dose calculation systems (Windows 10 version 1903 or later),
double-click Interactive logon: Do not display last user name (or Don’t
display last signed in for Windows 10 version 1709 or later).
16. Select Interactive logon: Prompt user to change password before
expiration.
18. Close the Local Security Policy dialog box.
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Install and Configure Server Roles (2008 R2 only)

1. On the Server Manager dialog, click Roles then select Add Roles.
2. At the Before you Begin dialog box, select Skip this page by default.
3. Select Next.
4. Select Application Server (then Add Required Features) and Remote
Desktop Services.
5. Select Next.
6. Select Next at the Introduction to Remote Desktop Services dialog box.
7. Select Remote Desktop Session Host and Remote Desktop Licensing.
8. Select Next.
9. Select Next on the Uninstall and Reinstall Applications for Compatibility
dialog box.
10. Select Do not require Network Level Authentication.
11. Select Next.
12. On the Specify Licensing Mode dialog box, select Per User.
13. Select Next.
14. On the Select User Groups Allowed Access To This RD Session Host Server
dialog box, Select Next.
15. On the Configure Client Experience dialog box, select Next.
16. On the Configure Discovery Scope for RD licensing dialog box, select
Configure a discovery scope for this license server, and Ensure this
workgroup.
17. Select Next.
18. At the Introduction to Application Server dialog box, select Next.
19. Select Web Server (IIS) Support and Add Required Role Services.
20. Select Next.
21. Select Next on the Introduction to Web Server (IIS) dialog box.
22. Ensure that ASP, ASP.net, Windows Authentication, and IIS 6
Management Compatibility are enabled.
23. Select Next.
24. Select Install on the Confirm Installation Selections dialog box.
25. Select Close on the Installation Results dialog.
26. Select Yes to restart now.
27. Log into the system as Administrator after the reboot and the installation will
resume.
28. Verify that the installation succeeded for Remote Desktop Services,
Application Server, and Web Server (IIS).
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29. Select Close.
Disable Data Sent to Microsoft (Server 2016 Only)

HKEY_LOCAL_MACHINE\SOFTWARE\Policies\Microsoft\Windows\Dat
acollection.
Right-cClick on Datacollection.
2. Select New > DWORD (32-bit) Value.
3. Enter the name “AllowTelemetry” and set the value to 0.
5. Right-click on the Start menu and select Run.
6. Enter services.msc and click OK.
8. Set the Startup type: to Disabled.
9. Select OK.
10. Close the Registry Editor dialog box.
Additional Configuration Changes for Windows Server 2016

5. Right-click on the Start button and select Run.
7. Select Yes to the UAC message if necessary.
8. Go to Local Computer Policy > Computer Configuration >
Administrative > Templates > Windows Components and click App
Privacy.
9. For every item listed except “Let Windows apps access trusted devices”, do
these steps:
• Double-click the setting and enable it.
• Under the Select a setting option, choose Force Deny.
• Select OK.
Go to Local Computer Policy > Computer Configuration > Administrative
Templates > Windows Components
Click Data Collection and Preview Builds.
10. Double-click Do not show feedback notifications.
11. Click Enabled.
12. Click OK.
Administrative Templates > Windows Components.
14. Click on Location and Sensors.
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16. Select Enabled.
17. Click OK.
18. Close the Local Group Policy Editor dialog box.
19. Click the Start then Settings.
20. Click on Update and Security then Windows Defender.
21. Disable these settings: Cloud-based Protection, Automatic sample
submission.
22. Select Yes in response to the UAC message.
23. Close the settings dialog box.
24. Right-click on the Start button and select System.
25. Select Advanced System Settings from the from the left-hand side of the
dialog.
26. On System Properties dialog box, select the Hardware tab.
27. Select Device Installation Settings.
28. Select No (your device might not work as expected) then Save Changes.
29. Select OK.and close the System dialog box.
31. Deselect Scroll inactive windows when I hover over them to Off.
Remote Desktop Users and Set RDP Color Depth
For Server 2008 R2:

1. Select Start > Administrative Tools > Computer Management.
2. Double-click Local Users and Groups.
For Server 2012 R2/Server 2016:

1. Right-click on the Start menu and select Computer Management.
2. Click on Local Users and Groups.
3. Right-click on the Users folder and select New Users.
• Add 5 users, “user1” through “user5”, with the password “test1.1”
then select these options for each user:
• Disable “User must change password at next login”.
• Enable Password Never Expires and click Create.
• Right-click on the new user and choose Properties.
• Select the Member Of tab and add each user to these groups:
• Power Users
• Remote Desktop Users
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4. Select OK to finish. Repeat steps 4 and 5 for each user.

5. Close the Computer Management window.
6. For Server 2008 R2, select Start > Administrative Tools > Local Security
Policy.
7. For Server 2012 R2/2016, right-click on the Start menu and select Control
Panel. Then select Administrative Tools > Local Security Policy.
8. Expand Local Policies and select User Rights Assignment.
10. Click Add Users or Group.
11. Select Object Types and ensure is checked.
12. Select OK.
13. Enter Power Users in the “Enter the object to select” field.
14. Select OK.
15. Select OK.
16. For Server 2012/2016 Systems only, proceed to step 24.
17. Close all dialog boxes except the Server Manager.
18. From the Server Manager dialog box, expand roles and double-click Remote
Desktop Services.
19. Select RD Session Host Configuration.
20. Right-click RDP-TCP and select Properties.
21. Select the Client Settings tab.
22. Set the Limit Maximum Color Depth to 32-bit.
23. Select OK. Proceed to section “Remote Desktop License Installation (2008
R2 only)”.
24. For Server 2012/2016, right-click the Start menu and select Run.
26. Go to Computer Configuration > Administrative Templates > Windows
Components > Remote Desktop Session Host.
27. Select Remote Session Environment.
28. Double-click Limit Maximum Color Depth.
29. Select Enabled and set the Color Depth to 32-bit.
30. Select OK and
31. Close the Local Group Policy Editor window.
32. Go to this section “Operating System License Installation”.
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Application Privacy
Administrative Templates > Windows Components and select App
Privacy.
5. For every item listed except “Let Windows apps access trusted devices” and
“Let Windows apps run in the background”, complete these steps:
a. Double-click the setting and enable it.
b. Select Force Deny.
c. Click OK.
Data Collection and Preview Builds

Administrative Templates > Windows Components and select Data
Collection and Preview Builds.
2. Double-click the Do not show feedback notifications.
3. Select Enabled.
4. Click OK.
Location and Sensors

Administrative Templates > Windows Components and select Location
and Sensors.
3. Select Enabled.
4. Click OK.
One Drive
Administrative Templates > Windows Components and select OneDrive.
2. Double-click Prevent the usage of OneDrive for file storage.
3. Select Enabled.
4. Click OK.
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Setting Windows 10 Components

1. Go to Local Computer Policy > Computer Configuration > Administrative
Templates > Windows Components and select Search.
2. Double-click Allow Cortana.
3. Select Disabled.
4. Click OK.
5. Close the Local Group Policy Editor dialog.
Windows Defender – Virus Protection

1. Right-click the Start menu and select Settings.
2. Click Update > Security > Windows Defender.
3. Select Open Windows Defender Security Center.
4. Select Virus & threat protection followed by the virus and threat protection
settings.
5. Turn off the Cloud-based Protection and Automatic sample submission.
6. Select Yes to the User Account Control messages.
7. Close the Settings dialog box.
Advanced Sharing
2. Select Network and Sharing Center.
3. Select Change Advanced Sharing.
4. Click the drop-down arrow next to All networks.
5. Set the following:
• Public Folder Sharing: Turn off Public Folder sharing
• File Sharing Connections: Enable file sharing for devices that use 40
or 56-bit encryption
• Password protected sharing: Turn off password protected sharing.
6. Click Save Changes and close all open windows.
Mouse Settings
2. Deselect the “Turn Scroll inactive windows when I hover over them”
option.
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Installing NVIDIA Graphics Driver

1. Insert the Monaco OS Update DVD (REF C#89946-nnnnn) into the
CD/DVD drive.
necessary.
2. Close any windows that open automatically.

3. Browse to the NVIDIA\<appropriate Windows version> directory.
4. Double-click the executable file and complete the installation of the NVIDIA
driver.
5. Restart the computer if necessary.
Configuring the Graphics Card

NOTE: For the Adaptive Anatomy algorithm to function, Monaco 5.51.00
requires that ECC memory be enabled except on the P2000.
1. Open an administrative PowerShell dialog and enter:

cd “C:\Program Files\Nvidia Corporation\NVSMI”
2. To get list of NVIDIA graphics cards installed, enter:
.\nvidia-smi –L
3. Make a note of the GPU number assigned to the graphics cards. This is an
example of the output:
GPU 0: Quadro P100 (UUID: GPU-…)
4. To find the ECC status on the P100 run this command:
.\nvidia-smi –i <GPU#> -q –d ECC
5. For example, use the output from the step 3, and run this command:
.\nvidia-smi –i 0 –q –d ECC
6. The output of the command should display this information:
Ecc Mode
Current: Disabled
Pending: Disabled
If the Current and Pending values are set to disabled, continue to step 5. If
the Current value is Enabled, continue to the next step.
7. To Enable ECC mode on the P100’s run this command:
.\nvidia-smi –i <GPU#> -e 1
For example, use the output from the step 3, and run this command:
.\nvidia-smi –i 0 –e 1
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Setting permissions on Global Objects

1. Open the Control Panel and select Administrative Tools.
3. Expand the Local Policies option and click User Rights Assignment.
5. Click Add User or Group.
6. Type Power Users in the Enter the object names to select field.
7. Select Object Types and make sure Groups is enabled.
8. Click OK 2 times to return to the Local Security Policy window.
9. Close the Local Security Policy window.
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Monaco® Installation and Upgrade Instructions Installing MonacoSim
Installing MonacoSim
For systems that previously had Focal, Monaco, or Focal 4D installed, go to the
Upgrading Monaco section. The following instructions only cover the MonacoSim
installation.
The differences between MonacoSim and Monaco are dose calculation and the
hardware platform. MonacoSim has no dose calculation functionality and
installation can happen on a variety of hardware platforms. Monaco provides
dose calculation and installation is only on Elekta approved hardware.
database manually.
1. Insert the Monaco DVD (P/N C#89945-nnnnn) into the CD/DVD drive.
necessary.
2. Navigate to the Monaco disc and double-click the Setup.exe. For Windows
10 X64/2012 R2 systems, click Yes to the User Account Control message.
3. The Software Update Wizard starts and automatically installs the
prerequisites for Monaco. The system may restart or prompt for a restart
several times during the prerequisite installation. If prompted for a restart,
select Yes and log back in as the administrator after each restart.
4. If the Monaco installer does not automatically start, click Start, click
Computer, navigate to the Monaco DVD, and double-click the Setup.exe.
5. Click Next on the Welcome to the Monaco Physics Database Setup Wizard.
6. Click Next on the Server Selection dialog box.
7. Click Next on the Select Installation Folder.
8. Click Install.
9. Click Finish on the Completing the Monaco Physics Database Setup Wizard.
10. At the Welcome to The Monaco Setup Wizard, check I have backed up my
data and closed all running applications and click Next.
11. Click Install.
12. Click Finish.
13. Restart the computer, if you are not prompted.
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Installing MonacoSim Monaco® Installation and Upgrade Instructions
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Monaco® Installation and Upgrade Instructions Upgrading Monaco
Upgrading Monaco
Uninstalling software
Follow the steps in this section to upgrade Monaco from Focal, Focal4D and
Monaco.
Before you can install or upgrade Monaco you need to uninstall the following
software:
• Focal
• Focal4D
• Monaco
• Physics database
• All Elekta Required Data
NOTE: Before you uninstall the previous version of Monaco, save the couch data
to a unique file name. The couch data folders are found in this directory:
C:\Users\Public\Documents\CMS\FocalData\Couches\CouchHold\Data.
For each couch that you have changed, rename that couch folder to
<couchname>_sav. Then the couch files are saved on upgrade.
Uninstalling Focal/Monaco/Focal 4D
1. Open the Control Panel.
2. Change the View by: to Small icons.
3. Select Programs and Features.
4. Select Elekta Required Data from the list.
5. Click Uninstall.
6. Click Yes to confirm that you want to uninstall the Elekta Required Data.
Windows removes the Elekta Required Data from your system.
7. For systems that have Monaco already installed, select Monaco Physics
Database.
a. Click Uninstall or right-click and select Uninstall/Change.
b. Click Yes to confirm you want to uninstall the Monaco Physics
Database. Windows removes the Monaco Physics Database from
your system.
8. Select the application, Focal, Monaco, or Focal 4D.
9. Click Uninstall.
10. Click Yes to confirm you want to uninstall the application. Windows removes
it from your system.
11. If not prompted for a restart, restart the computer.
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Upgrading Monaco Monaco® Installation and Upgrade Instructions
Installing OS updates
1. Insert the Monaco 5.51 OS Update DVD (REF C#89946-nnnnn) into the
CD/DVD drive. If the Prerequisite Wizard does not start automatically,
browse to the OS update disc using Windows explorer and double-click
OSUpdate.exe.
necessary.
2. Click Next to the welcome message.

3. Click Next to install the OS updates.
4. Your system may restart several times during the installation process. If it
does, log in after each restart and click Next to continue the installation.
5. On the Welcome to the Monaco OS Updates Setup Wizard, click Next.
6. Click Next to accept the default installation folder.
7. Click Install. For Windows 8.1/ Windows 10/Server 2012 R2/2016 systems,
click Yes to the User Account Control message.
8. Click Finish and the system restarts.
9. Log into the system as an administrator.
10. Remove the OS Update disc from the CD/DVD drive.
Upgrading Monaco
Upgrading Monaco 5.1X.0X to Monaco 5.51.01 on Windows 10
Complete the following steps when you upgrade from Monaco 5.1X.0X to
5.51.01 or later.
Uninstall Monaco Application

1. Right-click Start button.
3. Click Programs and Features.
4. Select Elekta Required Data.
5. Choose Uninstall.
6. Select Monaco Physics Database.
8. Select the Monaco application.
10. Restart the computer if necessary.
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Monaco® Installation and Upgrade Instructions Upgrading Monaco
database manually.
1. Insert the Monaco DVD (P/N C#89865-nnnnn) into the CD/DVD drive.
necessary.
2. Navigate to the Monaco disc and double-click the Setup.exe. For Windows
8.1 X64/2012 R2 systems, select Yes to the User Account Control message.
3. The Software Update Wizard starts and automatically installs the
prerequisites for Monaco. The system may restart or prompt for a restart
several times during the prerequisite installation. If prompted for a restart,
select Yes and log back in as the administrator after each restart.
If the Monaco installer does not automatically start, click Start, click
Computer, navigate to the Monaco DVD, and double-click Setup.exe.
4. Click Next on the Welcome to the Monaco Physics Database Setup Wizard.
5. Click Next on the Server Selection dialog box.
6. Click Next on the Select Installation Folder.
7. Click Install.
8. Click Finish on the Completing the Monaco Physics Database Setup Wizard.
9. At the Welcome to The Monaco Setup Wizard, check I have backed up my
data and closed all running applications, and click Next.
10. Click Install.
11. Mark the check box adjacent to Activate license for Monaco 5.51.00.
12. Click Finish.
13. Restart the computer.
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Upgrading Monaco Monaco® Installation and Upgrade Instructions
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Monaco® Installation and Upgrade Instructions Installing Monaco Training Data
Installing Monaco Training Data
1. Insert the Monaco Training Data DVD (REF C#89820-nnnnn) into your
computer’s CD/DVD drive. The installation program starts automatically.
necessary.
If the Training Data Installation program does not start automatically, open
Windows Explorer and navigate to the Monaco Training Data DVD and
double-click Setup.exe.
2. Click OK if any installer information dialog box open.
3. Remove the disc.
Licensing Monaco
You cannot use Monaco until the system verifies the license information. Contact
Elekta Software Customer Support to obtain the site key. You must have
administrator privileges to license Monaco products.
Before you complete these steps, make sure you have paper and writing utensils
available.
NOTE: Do not deselect the Conformal RT option in the "In Contract" column.
1. For Windows 7 X64/Server 2008 R2, click Start > All Programs > Elekta >
Edit License.
For Windows 8.1 X64/Server 2012 R2, from the desktop, select Start > Edit
License app.
For Windows 10 X64/Server 2016, from the desktop select Start > Elekta >
Edit License.
2. Call Elekta Software Customer Support. Provide your Elekta Customer
Support Specialist with the Monaco applications you have purchased, and the
system ID displayed in the EditLicense dialog box. Customer Support gives
you your activation key. Write down the activation key.
3. Verify that the applications you have purchased are selected in the In
Contract column.
4. Type the Site ID number and Activation Key digits.
5. Verify the Number of Instances. You may enter a number up to 3 for a local
Monaco installation.
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Installing Monaco Training Data Monaco® Installation and Upgrade Instructions
Figure 3: Edit License dialog box
6. Click Check License to verify that the information is valid. The Edit
Monaco License dialog box opens, stating that the activation code is correct.
7. Click OK.
8. Click Save & Exit if the installation is valid. Monaco is ready for
configuration.
9. If the Edit License dialog box does not open or there is a problem performing
the previous step, perform these steps:
a. Open Windows Explorer.
b. Go to C:\ProgramData\CMS.
c. Right-click the file license.
d. Select Rename.
e. Change the file name to license.old.
f. Right-click the file license.template.prod.
g. Select Rename.
h. Change the file name to license.
i. Complete steps 1-6 from the previous section.
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Monaco® Installation and Upgrade Instructions Configuring your software
Configuring your software
This section contains instructions to help you configure your Monaco software to
operate correctly.
Changing Published Focal Application to MonacoSim

If you have MonacoSim installed on a DirectAccess server, you need to change
the published shortcut from Focal to MonacoSim. You also need to update the
location of the application.
To change the name of the published applications, you need to have administrator
privileges on the DirectAccess server.
1. Log in to your Citrix server.

2. For XenApp 6.5: Click Start > Administrative Tools > Citrix > Management
Consoles > Citrix Delivery Services Console to open the Delivery Services
Console.
3. For XenApp 7.6 or later: Click Start > Citrix Studio.
4. If necessary, complete the Discovery Wizard to ensure that you do not have
Single Sign-On selected.
5. Click the Maximize button to expand the Form.
6. For XenApp 6.5: Click XenApp to expand the list.
7. For XenApp 7.6 or later: Click Delivery Groups.
8. Click Applications to expand the list.
9. Right-click the Focal icon.
10. Select Application Properties.
11. Click Name.
12. Type MonacoSim in the Display Name and Application Name fields.
13. Click Location.
14. Change the Command Line entry to:
C:\Program Files\CMS\Monaco\Monaco.exe
15. Change the Working Directory entry to:
C:\Program Files\CMS\Monaco
16. Click OK to save the entry.
17. Close the console and log off the server.
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Configuring your software Monaco® Installation and Upgrade Instructions
User Authorization setup (Standalone System)

Monaco systems can use either the native Monaco user authorization (local to the
Monaco system) or use a shared user authorization with MOSAIQ 2.80.00 or
later.
Monaco Standalone User Authorization Setup

Before you can use the Monaco software as a standalone system, you must create
the users and assign them to a specific permission group(s).
The User Authorization Database is where the systems administrator assigns

users and groups specific permissions in Monaco. To access the User
Authorization database, you must have administrator rights to the Monaco
system. In order to perform plan approval, the administrator must set up a user in
the database and give the appropriate permissions to approve plans in Monaco.
The administrator must turn on all permissions for the username: admin in order
for the administrator to have full access to Monaco. Permissions are set on the
host PC.
Creating Users and Permissions in Standalone User Authorization

You can assign users to certain groups based on the different group’s
permissions.
1. Launch Monaco.
2. Log in as:
Username: admin
Password: admin
3. Select Cancel on the Patient Selection dialog box.
4. Select Edit > User Authorization.
In the User Authorization database there are four pre-defined groups that you
can assign a user:
• Administrator: Administrators can change global settings and change

information in the User Authorization database
• Approver: Approvers can edit, export, and approve plans in Monaco.
• Physicist: Physicists can only edit physics data and overwrite existing
IMRT or SIM plans. (Permissions do not allow plan approval)
• Planners: Planners have permissions to edit and export plans with or
without approval.
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Creating a new User

1. Click Add at the bottom of the Entity Selection column.
2. The Create User dialog box opens, and you fill in the following information
accordingly:
3. Click OK to create the new user
OR
Click Cancel to leave the Create User dialog box.

4. In the Entity Editor column, select the Member Of tab.
5. Click Join.
6. In the Select Group window, highlight the group you want to assign the user
to and click OK.
7. In order to remove a user, highlight the user name in the Entity Selection
column and click Remove.
8. Click Commit to add the new user to the system.
NOTE: You must click Commit to apply your changes. When the User
Authorization database is successfully committed, a message is
written to the general log file on the server’s machine that includes
the date, time, and user who changed the database.
Creating a New Group

1. In the List Selection column, highlight Groups.
2. Click Add at the bottom of the Entity Selection column to show the Create
Group dialog box.
3. Enter the name and description of the new group and click OK.
4. You can edit the group Description from the Properties tab in the Entity
Editor column.
5. Select the Members tab in the Entity Editor column.
6. Click Add and select the users you want to add to this group and click OK.
7. Click the Permissions tab in the Entity Editor column and enable the
appropriate rights for the new group.
8. When you finish, click Commit to apply the changes.
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Editing Group Permissions and Users

Although we provide logical predefined groups for you to use, you may need or
want to create additional groups with different permissions than the predefined
groups. Follow these steps to create a new group.
1. Select Groups in the List Selection column.
2. Highlight the group you want to edit in the Entity Selection column.
3. In the Entity Editor column, click the Permissions tab.
4. You can enable or disable certain pre-defined permissions for the group.
5. If you create a new group, add new users under the Members tab.
6. Click Add and select the users you want to add to the group.
7. You can remove users from an existing group by selecting Remove in the
Members tab and highlighting the group’s users you want to remove.
8. Click Commit to apply your changes.
Monaco/MOSAIQ Shared Standalone User Authorization

Setup
Contact Elekta Customer Support to setup Monaco to use a shared user
authorization and/or patient demographics with MOSAIQ.
Pointing multiple Monaco systems to one data location

Multiple Monaco systems can be configured to point to a single Mimer database
FocalData location, and DICOM import/export location. These steps are optional
and if you do not feel comfortable completing, contact Elekta support.
If the Mimer database is not a local installation, you must install the
Physics database manually.Before you start
The following assumptions are made:
• Mon1 is the FocalData location and is fully configured.
• Mon2-n points to Mon1
• Mon1 and Mon2-n are on the same Domain
• The Mimer database is a local installation.
1. Launch Monaco on Mon1.
2. Click the Elekta button and click Settings to open the Settings dialog box.
3. Share out the data location and close Mon1.
a. Launch Mimer Administrator on Mon2-n and select the Remote tab.
b. Select File > Add.
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c. Set the following:

i. Database Name: Monaco_Physics_DB
ii. Node Name: <IP Address of Mon1>
d. Click Yes to overwrite the existing Monaco_Physics_DB.
e. Exit the Mimer Administrator.
f. Open the registry on Mon2-n and explore to HKLM\SOFTWARE
\Computerized Medical Systems\Treatment Unit Storing.
i. Ensure the KernelsLocation is set to \\<IP Address of
Mon1>\DoseToolKit.
g. If the customer is going to use a single DICOM export location, open
the registry and explore to HKLM\SOFTWARE\Computerized
Medical Systems\DICOM.
i. Set DCMXprtFilePath to \\<IP Address of Mon1>\FocalData\DCMXprtFile.
h. If the customer is going to use a single DICOM import location,
open the registry and explore to
HKLM\SOFTWARE\Computerized Medical Systems\DICOM
IMPORT SETTINGS.
i. Set DICOM DataLocation to \\<IP Address of Mon1>\FocalData
\DICOMData\Import.
i. Set the FocalData location.
4. From the registry, explore to HKLM\SOFTWARE\Computerized Medical
Systems. Set the DataLocation to \\<IP Address of Mon1>\FocalData.
Designating the location of the User Authorization server

You use this dialog box to designate the location of the user authorization server.
1. Click the User Authorization tab under Settings.

2. Click the Connect to localhost radio button if the user authorization server is
installed on the local machine.
3. Click the Connect to: radio button and enter and make entries to the
IP Address – the IP Address of the host machine.
Port – This is the port address on the host machine.
NOTE: Use the Connect to option if the user authorization server is installed
on another workstation.
4. Click Test to make sure the server connections work and click OK.
If you cannot connect to the User Authorization Server, you might need to start it
manually:
1. Open the services.msc file. In Windows 7, click the Start button and type
services.msc in the Search field. Click services.msc. In Windows 8.1, and
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Windows 10, open the Charms bar and type services.msc in the Search field.
Click services.msc from the results list.
2. Right-click the Elekta User Authorization Server and select Activate.
3. Close services.msc.
Setting up Monaco Shares
NOTE: These assumptions are made when you set up Monaco Shares:
• Each FocalData location is shared.

• Permissions are set for each FocalData location which gives access to
specific users or groups.
• Mon1 and Mon2-n are on the same Domain or same workgroup.
1. On each conventional Monaco system, complete these steps:
a. Browse to the FocalData location (the default location is
C:\Users\Public\PublicDocuments\CMS\FocalData)
b. Right-click the FocalData directory and select Properties.
c. Select the Sharing tab and share the FocalData directory to
chosen users or groups.
d. Select the Security tab and add the users or groups with these
permissions:
 Modify
 Read & execute
 List folder contents
 Read
 Write
2. Start Monaco on each system.
3. Double-click the Elekta icon then click Settings.
4. On the Servers tab, select Monaco Share.
5. Enter a name in the name field followed by the UNC path to the
FocalData location
a. Name: z840
b. Server: \\z840\FocalData
6. Click Add.
7. Select OK.
8. Close Monaco.
9. If the Collapsed Cone or Electron Monte Carlo beam models are
necessary, the tele machines and treatment units must be loaded using
the Treatment Unit Storing utility. Refer to the Treatment Unit Storing
section for more information.
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Patient Data Transfers

You can set up workstations to transfer patient data from one system to another.
Activate Network Security: LAN Manager Authentication Level
Windows 7
2. Select Large Icons or Small Icons.
3. Click the Administrative Tools icon.
6. Click Security Options.
7. Browse and double-click Network security: LAN Manager
Authentication level.
8. Select Send LM & NTLM or use the NTLMv2 session security if it is in
the drop-down list.
9. Click OK.
10. Close Local Security Policy window.
Windows 8.1
a) Browse and double-click Network security: LAN Manager
b) Select Send LM & NTLM or use the NTLMv2 session security if it
is in the drop-down list.
c) Click OK.
d) Close the Local Security Policy window.
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Windows 10
NOTE: Follow the directions in the Create Control Panel Shortcut for
Windows 10 version 1703, before you start this procedure.

the drop-down list.
9. Click OK.
Windows 2008 R2
the drop-down list.
9. Click OK.
Setup Data Transfer

The procedures within this section are optional.
1. Start Monaco.
2. Click the Elekta button, and then click Settings to open the Setup dialog
box. Continue with the following procedures.
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Allow Other Monaco PCs to Access Your Data

1. Click the Data Location tab.
2. Check the Share Data Location box. (To disable this function, clear the
box.)
Access Data on Other Monaco PCs

1. Click the Focal Share tab.
2. Enter the name and server of the Monaco PC you want to access in the Name
and Server fields. The server must be in the format: \\Machine Name\Focal
Data Location. The name can be whatever you want to call the server.
3. Click Add to add the Monaco PC to your list of accessible Monaco PCs in
the Known Shares list.
Updating Monaco workflow settings

Preferences Tab
If you want clinic information to show on printed materials, you must enter the
information in Preferences.
1. Select the Preferences tab under Workflow.

2. Type a name in the Hospital/Clinic field.
3. Enter the number of days you want to Keep log messages.
4. Mark if you want to Allow users to save over approved plans. This will allow
users to write over plans that have been approved when they save plans.
5. Mark if you want to Allow users to DICOM export unapproved plans.
This will let users use DICOM to send unapproved plans to other users.
6. Mark if you want to Activate single export for Apex and DICOM
Applicator ID for Micro-MLC.
7. Place a check mark next to Calculate SUV for loaded PET data
automatically. (Only available if you have SUV Licensing)
8. Enter a value (in cm) to Set Peak Value Sphere diameter to.
9. Enter a value (in hours) to Set maximum time between the injection and
acquisition to. (Only available if you have SUV Licensing)
10. Click OK.
Graphical Preferences tab

Use this tab to set display preferences for isodose control bars and cones.
Display Contours with Thick Lines

Change the setting in the Default Thickness of 2D Isoline drop-down list.
3D Rendering Style
Select Default 3D Rendering Style from the drop-down list.
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Changing BEV View Increments

For 3D Static Arc plans, you can change the increments of the view angle. If the
increment you enter does not cleanly divided into 360 degrees, then the final
increment will be at the 0-degree angle, regardless of the previous increment
Type a new value in the Visualization Increment field.
Tolerance Table tab
Creating a Tolerance Table

Before you can add a Tolerance Table to a DICOM plan for export, you need to
define Tolerance Tables on the Tolerance Table Tab on the Settings dialog box.
1. Click the Tolerance Table tab under Workflow.

2. Select the Installation for the Tolerance Table.
3. Select a Clinic for the Tolerance Table.
4. Type the name of a Tolerance Table in the Name field.
5. Click Add. You will see the Tolerance Table appear in the Tolerance Table
Names list.
6. Click OK.
Deleting Tolerance Tables

If you no longer need a tolerance table, you can delete it from the Tolerance
Table Tab of the Settings dialog box.
1. Click the Tolerance Tables tab under Workflow.

2. Select the Installation for the Tolerance Table.
3. Select a Clinic for the Tolerance Table.
4. Select the name of the tolerance table in the Tolerance Table Names list.
5. Click Delete and click OK. This will remove the tolerance table from the list.
Rx Sites tab
Creating an Rx Site
Before you can add an Rx Site to a DICOM plan for export, you need to define
them on the Rx Sites tab on the Settings dialog box.
1. Click the Rx Sites tab under Workflow.

2. Select the Installation for the Rx Site.
3. Select a Clinic for the Rx Site.
4. Type the name of an Rx Site in the Name field.
5. Click Add. You will see the Rx Site appear in the Rx Site Names list.
6. Click OK.
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Deleting an Rx Site
If you no longer need an Rx Site, you can delete it from the Rx Sites tab of the
Settings dialog box.
1. Click the Rx Sites tab under Workflow.

2. Select the Installation for the Rx Site.
3. Select a Clinic for the Rx site.
4. Select the name of the Rx Site in the Rx Site Names list.
5. Click Delete and click OK. This will remove the Rx Site from the list.
Monaco Settings – Physics

Ports & Materials
Use this tab to define ports and materials that your clinic uses.
1. Click the Ports & Materials tab under Physics.

2. Click the drop-down arrows in the Installation and/or Clinics field.
3. Enter the defaults to be used for all plans started in Monaco in the Materials,
Material Thickness (cm), and HVL fields.
4. You can update the value in the Default Bolus Electron Density: field.
5. Click Apply to go to a different tab or click OK to accept the changes.
Laser System
You need to perform this setup if you want to use the Setup Reference Distance
tool in Monaco to determine shifts or if you have movable lasers in your CT
room and would like to send a file with the shift values to the LMS system.
1. Click the Laser System tab under Physics.

2. Select the laser system type − Gammex or LAP.
3. Enter the calibration distance for your CT. You may need to contact your
CT or laser system vendor for this information.
4. Enter the units you want Monaco to use for the LMS and couch position
readouts.
5. Enter the leftmost and rightmost readings for your movable sagittal lasers.
Use positive and negative values, if necessary.
6. Enter your highest and lowest readings for your movable coronal lasers. Use
positive and negative values, if necessary.
7. Provide an appropriate answer to whether or not the couch position readings
increase or decrease when the couch moves towards the gantry.
8. If you have a Picker series IQ or PQ scanner, check the box if you would
like Monaco to report absolute couch readings instead of relative shift values
and click OK.
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Share Laser System Folders

For your laser marking system to access the data created in Monaco, you must
configure the laser system folder to share with the laser marking system.
1. Open Windows Explorer.

2. Open the Monaco Data folder (for example, C:\Documents and Settings\All
Users\Shared Documents\CMS\FocalData).
3. Go to step 4 if the system automatically created the lasermark folder. If there
is no folder, go to File > New > Folder. The system creates a directory
named New Folder. Rename the new folder lasermark.
4. Right-click the lasermark folder and select Share or Sharing and Security,
depending on the version of Windows. If Share is not available, you may
need to turn on File and Printer Sharing for Microsoft Networks. This
may require the involvement of your Information Systems department.
Figure 4: Use Windows Explorer to share Laser System folders
5. Share the lasermark folder and click OK.

6. Set up the laser marking system so that it accesses the lasermark folder.
7. Test the connection. To do this, perform the following procedure:
a. Click the Elekta button, and then click Settings in Monaco and click
the Laser System tab in the Setup dialog box to display the marking
system settings.
b. Enter the laser marking system settings as needed.
c. Click Open Patient to select any patient file. If needed, refer to the
Monaco Training Guide on how to open a patient file.
d. Click Scan and Setup Reference from the Sim menu to display the
Setup Reference dialog box.
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e. Enter the scan reference and setup reference points. Make sure you
check Lock Scan Reference. Then, select the orientation of the
patient or phantom in the Patient Orientation when Scanned drop-
down menu.
f. Click Send to Laser.
g. Verify that a message appears that reads as follows: “Laser file
<filename > written successfully” where <filename > is the name of
the file created in lasermark folder. Additionally, you should verify
that the file was in fact created in the lasermark folder.
If you are using a Gammex laser marking system, the system names the file after
the patient ID (for example: smith.cts or autorun.cts if AutoRun is enabled).
If you are using a LAP IsoMark laser marking system, the system always names
the file lapdata.dat.
DICOM Machine Mapping

Use this tab to map a local machine name to an exported machine name.
1. Click the DICOM Machine Mapping tab under Physics.
2. Enter an Exported Machine Name for any of the available local machine names.
3. For MicroMLCs, enter an Applicator ID or select a default option (Apex
2.5, DMLC 0.30, DMLC 0.50, and DMLC 0.70).
4. For MicroMLCs, enter an Accessory Code if the OIS requires it.
5. Click OK.
MLC Dynamic Parameters

Use this dialog box to define dynamic MLC parameters for your machine type.
Monaco uses these parameters for dynamic plans.
You will not see this tab if:
• You do not have permissions to change the physics settings
• You have a patient loaded.
1. Click the MLC Dynamics tab under Physics.
2. Click the drop-down arrow in the Installation field to select an installation.
3. Click the drop-down arrow in the Clinic field to select a clinic.
4. Click the drop-down arrow in the Machine field to select a machine.
5. Mark a box in the Default? column to set as the default.
6. Click OK.
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MLC Geometry
Use this dialog box to review the MLC geometry parameters and to make minor
adjustments of those parameters if necessary.
When you click OK, you save changes and close the dialog box. You will see the
following warning message:
The change you are about to make will change the beam model. Verify
the agreement between calculated and measured data before using this
model clinically. Plan deliverability must be verified. Do you wish to
proceed?
You must verify the calculations against measured data before you accept the
machine for clinical use.

1. Click the MLC Geometry tab under Physics.
2. Click the drop-down arrow in the Installation field to select an
installation.
5. Mark a box in the Default? column to set as the default.
6. Click OK.
MLC Leakage
Use this dialog box to account for the dosimetric effect of beveled MLC leaf
corners. You need a current beam model to use this functionality. Refer to
Monaco Dose Calculation Technical Reference (LRMMON0001) and Post
Modeling Adjustment of MLC Parameters (LRMMON0003) for more
information on MLC corner leakage.
1. Click the MLC Leakage tab under Physics.
5. Mark a box in the Default? column to set as the default. The dialog box
defaults to 0.00 for all leaf pairs unless it has previously been defined in the
beam model.
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6. Click OK.
Micro-MLC Parameters
Use this dialog box to define parameters for add-on mMLCs.
1. Click the Micro-MLC Parameters tab under Physics.
5. Mark a box in the Default? column to set as the default and click OK.
Wedge Parameters
Use this dialog box to make or edit wedge parameters. You need to have Physics
group permissions to make changes to the wedge parameters. The wedge
parameters are only available to the local clinic.
1. Select your Installation, Clinic, Machine and Wedge Name.
Stereotactic Cones Parameters

Use this dialog box to set DICOM export values for stereotactic cones, which is a
licensed feature.
1. Select your Installation, Clinic, Machine and Applicator ID.

2. Confirm that the Field Size, Collimator Angle, Nominal Cone Size, Source-
to-cone Distance, and Serial Number are correct.
3. Type a value for each parameter. Values must be the same as the values in the
receiving system. Values are:
• DICOM Accessory Code – This code verifies the base plate for the
plan.
• DICOM Applicator ID – A user-defined identification code for the
applicator.
• DICOM Applicator Type – Shows the type of applicator. Must be
PHOTON_CIRC or STEREOTACTIC.
• DICOM Applicator Description – A brief description of the applicator.
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Treatment Unit Mapping

Before you can create treatment plans, you need to create treatment unit
mappings. Treatment Units are a group of all associated beam models of a linear
accelerator under one ID. During planning, you can then select the Modality
(photon/electron), Algorithm and Energy used to generate a plan for that linear
accelerator.
You cannot have multiple machines with the same energy and calculation
algorithm assigned to the same treatment unit, unless you model one of the units
as a Flattening Filter Free unit.
Once you map a machine to a treatment unit, the system disables any inconsistent
machines for that map. You will see a warning icon next to disabled machines.
You must have Physics permissions to create a treatment unit. Follow these steps
to do so:
1. Select your Installation and Clinic.
2. Type the name for your Treatment Unit (TU).
3. Press the TAB key.
4. Mark the check box next to one or more machines from the list.
5. To sort the list of machines, you can click the header of one of the columns.
Mark the Show Unselected field to show only machines that you have not
selected.
6. Click Define/View to open the Treatment Unit Characterization dialog box.
7. Make any changes to the values on the dialog box. These changes apply to all
machines within the treatment unit.
8. (Optional) Click Customize Labels to type new names for the X and Y jaws
on the Collimator Jaw Labels dialog box.
9. (Optional) Click OK to close the Collimator Jaw Labels dialog box.
10. Click OK to close the Treatment Unit Characterization dialog box and return
to the Treatment Unit Mapping dialog box.
11. Click Save to save your treatment unit. Note that the TU status defaults to
“testing”. This allows you to test the TU characteristics within the planning
system before you allow general access to the TU for clinical use. Once you
have the TU validated for use, you can change the status to “clinical” so it
becomes available in the system for those with planning privileges to access.
Plans generated with a treatment unit in the “Testing” status will have “for
non-clinical” use appear in the UI and reports.
12. Click OK to close the dialog box.
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Treatment Unit Storing

If your clinic will use the Collapsed Cone or electron Monte Carlo algorithm, you
need to store the treatment units in the database. To do this, you use the
Treatment Unit Storing application.
NOTE: If your clinic uses photon Monte Carlo, you do not use the Treatment
Unit Storing application to install the treatment units. For details, see
Adding Treatment Units—Photon Monte Carlo in this chapter.
You also need to perform daily back-ups on your database. Use the Backup and
Restore Utility to do this. See Appendix C for instructions.
Adding Treatment Units—Collapsed Cone or Electron Monte Carlo
It is important that you drop the treatment unit onto an empty space
WARNING
in the database window; otherwise the data will not be stored. The
system will display a warning message if the treatment unit is not
dropped to the correct location.
You must have the modeled treatment unit information from Elekta. For each
treatment unit, this includes:
• An XML file
• Several data files
You must close Monaco before you open Treatment Unit Storing. Do not start
Monaco while you install your treatment unit machines.
1. Insert the CD or media used that contains the treatment unit data.
2. Open the Treatment Unit Storing application:
• Windows 8.1 and Windows 10: Open the Charms tab, and type
Treatment Unit Storing in the Search field. Select it from the list of
apps.
3. Select File > Select File to open a browse window.
4. Browse to the media that contains your treatment unit data.
5. Select the XML files and click Open. The treatment units will appear in the
left column of the application.
6. Click a machine and drag it into the right column. To store a wedge or
applicator, drag it from the left column to below the treatment unit in the
right column.
7. Type the User name and Password in the confirmation window. Contact
Elekta Global Support for the User name and Password.
8. Click Yes to confirm you want to transfer the machine data.
In the Treatment Unit Storing application, press F1 to get further help.
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Adding Treatment Units—Photon Monte Carlo

If your clinic uses the photon Monte Carlo algorithm, Elekta will deliver a
complete machine and beam model folder structure, one for each energy and
flattening filter combination. You need to manually copy this folder to a
designated folder in the Monaco file structure, using Windows Explorer.
You must close Monaco before you install your photon Monte Carlo machine
folder. Do not start Monaco while you install your treatment unit machines.
CAUTION If the Monaco system is connected to a XiO server, please make sure Monaco uses a
unique machine model ID which does not exist in XiO. Otherwise, you need to
rename the model ID before you install the model.
After you confirm there is no model ID conflict, do the following:
1. Find out your Monaco system installation type by selecting "Start >All
Programs > Elekta > Edit License" in Windows. If the option "Standalone"
is checked, it is a standalone installation. Otherwise, it is a non-standalone
installation.
2. Run Monaco and find the Monaco data location by selecting "Elekta
Application button > Settings > Servers > Data Location", hereafter
referred to as "\\MonacoDataLocation." On a non-standalone system, you
also need to find the installed XiO Server by selecting "Elekta Application
button > Servers >XiO Server." Write down the server's name, hereafter
referred to as "XiO_Server_ID."
On A Non-Standalone System:
1. Use Windows Explorer to browse to
"\\MonacoDataLocation\Installation\1~QA Clinic\tele". Please make a
backup of this "tele" folder first. Normally there are several demo models in
this folder for training purposes; we suggest you delete those demo models
except the model "IECMachine", which will be used for DICOM RT PLAN
import purposes. Also use Windows Explorer to browse to:
"\\MonacoDataLocation\XiO_Server_ID\Clinic_ID\tele” and delete all
unwanted demo models there.
2. After you clean up the unnecessary models, please save your own model
folder(s) in "\\MonacoDataLocation\Installation\1~QA Clinic\tele".
3. Run Monaco, select "Elekta Application button > Settings > Servers >
XiO Server." Select an existing XiO server and click the "Update Server"
button. If it is the first time that you are trying to connect to an XiO server,
you can add your XiO server now.
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On A Standalone System:
Save the model folder into the "tele" directory under your own clinic. Example:
"\\MonacoDataLocation\Installation\Your_Clinic\tele" and
“\\MonacoDataLocation\Installation\1~QA Clinic\tele”
Check the installation

1. Map the model to a "Treatment Unit." Click Elekta Application button >
Settings and click the Treatment Unit Mapping tab.
2. Run Monaco and open a patient in the working clinic.
3. Start a new plan and confirm that the treatment unit and energy for Monte
Carlo algorithm is available and correct on the General Tab of the Beams
Control.
WARNING It is your responsibility, as a qualified Medical Physicist, to review and verify all
delivered models, and the resulting dose calculations in Monaco, before clinical use in
patient treatment plans.
DICOM Export
This procedure requires you to enter or edit values in the DICOM Settings dialog
box in Monaco.
DICOM Preferences
Use the DICOM Settings dialog box to configure certain parameters used when
you import or export DICOM data.
1. Click the Elekta button, select Setup > DICOM Settings in Monaco. The
DICOM Settings dialog box opens.
Figure 5: DICOM Settings dialog box
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LIIMON0551 / 5.0 / 2019-12-13
2. Review the default location in the DICOM File Export Location field. If
this location is not acceptable, click the Browse button and define another
location. This defines where the system stores the data when you perform a
DICOM Export to File operation.
3. See the instructions on how to export DICOM data to a file in the Using the
DICOM Export Dialog box Online Help topic.
NOTE: The complete File Export Location is as follows: C:\Documents
and Settings\All Users\Documents\CMS\FocalData
\DCMXprtFile.
4. Enter a SCU application entity (AE) title in the SCU Name field to use when
you want to export DICOM data. You can enter any valid SCU name for the
Monaco DICOM Export application. The system uses this AE title when it
communicates with third party systems (SCPs).
5. Check the Store Incoming DICOM Images box to save all imported
DICOM images. You must mark this check box before you import images in
order to export the images later using the Images check box in the DICOM
Export dialog box.
NOTE: You must check this box if you want to export images, with RT
structure sets or RT plans, to a third-party system for example. You
may check or clear this box as needed. When checked, the system
stores incoming DICOM data in a folder named DCMData in the
imported patient folder.
6. Click OK.
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Configure a DICOM Printer for DRR Export

Before you begin, you must have the following information about the DICOM
printer you want to configure:
• Application title
• Port number
• Host
Note that the AE title of the Monaco DICOM Print client is PRINT_SCU. Only a
qualified engineer from the printer vendor must enter this into the DICOM
printer device.
1. Open the DICOM Settings dialog box and click Add. A blank row appears.
Figure 6: DICOM Settings window

2. Complete the Label, AE Title, Host and Port fields.
3. Press the Tab key on your keyboard to complete the row addition.
4. Select the new row.
5. Click Test. If all settings are correct, you will get the following message
window.
Figure 7: Monaco test window - Correct

If you have an incorrect setting, you will see the following message:
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Figure 8: Monaco test window - Incorrect

Edit the settings and go back to step 2 until you pass the test function.
6. Click OK.
DICOM Scanner
Follow this procedure to import image data from a:
• CT
• MRI
• PET scan
• Another DICOM source
Enter the following data:
• DICOM application title: MONACO_SCP
• Port number: 104
• IP address: IP address of the Monaco PC
Test the scanner connection. Send a single studyset that contains only transverse
cross sections, without scouts, pilots, or scannergrams.
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Monaco® Installation and Upgrade Instructions Installing Monaco commissioning Utility
Installing Monaco Commissioning Utility
Monaco Commissioning Utility (MCU) is a QA and commissioning tool that allows you to
compare Monaco-calculated DICOM RT dose to scanned measurements. For more
information, see the Online Help of Monaco Commissioning Utility.
You can install Monaco Commissioning Utility on a Monaco workstation or on your

computer. For assistance at any time during or after the installation, contact Elekta Software
Customer Support.
System Requirements
If you install MCU on a Monaco workstation, there will be no extra system requirements. If
you install MCU on your own computer, see the system requirements below:

Operating System Windows 7, Windows 8.1, Windows 10, 64-bit
systems
Microsoft.NET Framework 4.5.2
Hard Drive Space 22.4 MB
Installing and Licensing Monaco Commissioning Utility

Follow these steps to install and license Monaco Commissioning Utility.
1. Insert the Monaco DVD P/N C#89945-nnnnn into the CD/DVD drive.
NOTE: nnnnn is the release/patch number such as 55101, 55100, as necessary.
2. Navigate to the Monaco disc and open the Monaco Commissioning Utility folder.
3. Double-click SetupMCU_x64_Release.msi. The software installation wizard starts.
4. Follow the instructions on the wizard to install the software. On the last window, be
sure to select this checkbox: Activate License for Monaco Commissioning Utility.
5. Click Finish.
• Monaco Commissioning Utility is installed.
• The EditMCULicense window opens for you to license the software.
NOTE: The EditMCULicense window does not appear if you did not select the
check box in Step 4. In this case, you need to manually open the window.
See Navigating to the MCU License Editor.
6. On the EditMCULicense window, type your Site ID.
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LIIMON0551 / 5.0 / 2019-12-13
Installing Monaco commissioning Utility Monaco® Installation and Upgrade Instructions
7. Type your Activation Key.

8. Verify that the check box next to MONACO_COMMISSION_UTILITY is selected
in the In Contract column.
9. Click Check License.
10. Click OK to this message: “Activation Code is correct”.
NOTE: If license check fails, contact your local support center.
11. Click Save & Exit. Monaco Commissioning Utility is ready for use.
Navigating to the MCU License Editor

After you click Finish on the installation wizard, if no window appears to license the
software, you need to manually open the MCU license editor.
Do either of the following:
• Go to this file location: C:\Program Files\Elekta\Monaco Commissioning

Utility\Utilities\ and double-click EditMCULicense.
The default installation directory is C:\Program Files\Elekta.
68 ©©©© 2019, Elekta, Inc.

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European Union Authorized Representative
Manufacturer
Elekta, Inc. Elekta Solutions A.B.
13723 Riverport Drive Kungstensgatan 18, Box 7593
Suite 100 SE-103 93 Stockholm
Maryland Heights, MO 63043 Sweden
USA Phone: +46 8 587 254 00
Phone: +1.800.878.4267 Fax: +46 8 587 255 00
Fax: +1 314 812 4491 Email: eu_ar@elekta.com
Monaco®
www.elekta.com Human Care Makes the Future Possible

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Acknowledgement of other trademarks and trade names

GLOBAL ELEKTA SOFTWARE SUPPORT

ii ©©©© 2019, Elekta, Inc.

© 2019, Elekta, Inc. iii

LIIMON0551 (4.0) 2019-08-12 Sections updated for the Monaco 5.51.01

iv ©©©© 2019, Elekta, Inc.

© 2019, Elekta, Inc. v

vi ©©©© 2019, Elekta, Inc.

Mouse Settings ..................................................................................................................... 34

© 2019, Elekta, Inc. vii

On A Non-Standalone System: .............................................................................................. 62

viii ©©©© 2019, Elekta, Inc.

© 2019, Elekta, Inc. ix

x ©©©© 2019, Elekta, Inc.

This upgrade package contains the following media:

• Monaco Release DVD (REF 89945-nnnnn)

• Windows 7 (SP1) 64-bit Professional

NOTE: Windows 10 versions below 1903 are NOT supported on Monaco

© 2019, Elekta, Inc. 1

Monaco with Dose Functionality – Minimum Hardware Configuration

You can only upgrade Monaco with dose functionality on validated

2 ©©©© 2019, Elekta, Inc.

Monaco with Dose Functionality – Graphics Card Requirements

The supported graphics cards for Collapsed Cone are:

• Tesla K20 (Z820, Z840, Gen8 V1 & V2)

• Tesla K20 (Z820, Z840, G8 V1 & V2)

For installation, contact your Monaco service partner.

© 2019, Elekta, Inc. 3

Monaco Sim with No Dose Functionality – Minimum Hardware

Monaco Sim with No Dose Functionality – Graphics Card

• Tesla K20 (Z820, Z840, G8 V1 & V2)

4 ©©©© 2019, Elekta, Inc.

© 2019, Elekta, Inc. 5

If you purchased hardware from Elekta, contact Customer Support.

6 ©©©© 2019, Elekta, Inc.

Monaco and MonacoSim Installation

Before you begin

NOTE: Monaco does not include a procedure to automatically back up data.

Certain Novell networks need special administrative privileges to upgrade

© 2019, Elekta, Inc. 7

Configuring the Windows Desktop Operating System

Upgrading Windows 10 Professional x64 to version 1903

1. To see which version of Windows 10 is installed, do these steps:

8 ©©©© 2019, Elekta, Inc.

Workstation Operating System Configuration

1. Login to the OS.

If the build number is lower than 18362, complete section Upgrading

Using Microsoft Windows media

© 2019, Elekta, Inc. 9

4. Enter Focus1.1 in the password field.

NVIDIA Graphics Driver Installation

Windows 10 version 1903 Scripted Automatic OS Configuration

2. Right-click the Start menu.

10 ©©©© 2019, Elekta, Inc.

8. Using Windows Explorer, browse to the

a. Click the Control Panel icon on the desktop.

© 2019, Elekta, Inc. 11

l. Click Change Security and Maintenance Settings.

GPU Configuration (GP100 only)

1. Open an administrative command prompt.

This is an example of the command result:

12 ©©©© 2019, Elekta, Inc.