I use AlignRT with Monaco since 2019 and yes, we have exactelly the same bad look on patient surface, with big holes that are affecting ROIs…
Hopefully we also use another software for contouring (ArtPlan). External contour on this other software is heavier in ko but very good looking on AlignRT ! And the use of these new external surfaces doesn’t affect fps. So now we use ArtPlan for all external contouring.
Another thing to try on monaco : the way you generate external contour : clic outside of the surface versus inside the patient may change the way the structure is generated.
I hope it will help !