Automated Prostate Cancer Detection on T2-Weighted MRI Using a Dual-Stream Attention Network: A Study on Private Saudi Clinical Data and Public Benchmark Datasets

Background: The steady rise of prostate cancer in Saudi Arabia signals a critical public health shift that requires immediate investment in early detection and prevention to mitigate a future clinical crisis. Accurate diagnosis using multiparametric MRI and PI-RADS scoring remains challenging, as interpretations are highly experience-dependent and subspecialized radiologists are limited. Methods: To address this gap, this study introduces a novel Dual-Stream Attention Network designed to automate the classification of low-risk (PIRADS 2-3) versus high-risk (PIRADS 4-5) lesions from T2-weighted MRI. Leveraging a ResNet50 backbone, the architecture employs parallel streams for Local and Global Feature Processing, each enhanced by a Channel-Spatial Attention module to highlight diagnostically relevant regions. These features are integrated through a Cross-Stream Fusion mechanism and a gate-controlled Adaptive Feature Fusion module to optimize multi-scale information. The model was developed and validated on a regional dataset of 3850 images from Jazan Specialist Hospital and Prince Mohammed bin Naser Hospital. This research provides a standardized, high-precision diagnostic path tailored to the Saudi Arabian population, conducted under institutional review board approval (No. 25138). Results: The proposed dual-stream attention network achieved an accuracy of 97.8% on the validation set and 96.4% on the test set, demonstrating high performance and generalization capabilities in classifying prostate lesions from Saudi patient populations. Conclusions: The proposed dual-stream architecture with novel attention and fusion mechanisms demonstrates high effectiveness for prostate cancer classification from T2-weighted MRI in Saudi clinical settings. This represents the first deep learning model specifically trained and validated on Saudi Arabian prostate MRI data, with the potential to address the shortage of specialized expertise and improve diagnostic efficiency in the Kingdom.