Matlab-Based Fusion of 3D Space And 3D ToF MRA Brain MRI for Trigeminal Neuralgia Diagnosis

Background: Trigeminal neuralgia (TN) is often associated with neurovascular compression in the trigeminal nerve root entry zone, necessitating the simultaneous visualisation of nerves and blood vessels. Fusion of 3D SPACE and 3D TOF MRA images provides an integrated neurovascular view; however, not all hospitals have fusion software. This study developed a MATLAB-based image fusion method as an alternative and evaluated its equivalence to hospital-based fusion software.Methods: This study employed a descriptive quantitative research design, conducted in November 2025 at Diponegoro National Hospital and Dr Kariadi General Hospital in Semarang. A total of 16 brain MRI datasets (3D SPACE and 3D TOF MRA) were fused using hospital software and the MATLAB fusion application (MATLAB R2025b GUI). The fusion results were assessed by specialist radiologists. Diagnostic performance metrics (sensitivity, specificity, NDP, NDN, accuracy) were calculated, and paired differences were tested using the McNemar test. Intra-observer reliability was assessed using percentage agreement and Cohen’s Kappa.Results: MATLAB fusion yielded a sensitivity of 90.91%, specificity of 80.00%, NDP of 90.91%, NDN of 80.00%, and accuracy of 87.50%; the McNemar test (p=1.000) indicated no significant difference. Intra-observer reliability was very good (percent agreement 94%; Kappa 0.875). These findings indicate that MATLAB-based fusion is equivalent to hospital software fusion on the study data and has the potential to serve as an alternative in facilities without fusion software, provided that registration standardisation and user training are in place.