{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:03:10Z","timestamp":1789516990399,"version":"build-2803163510"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultrasound Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>PurposeThe aim of this study was to describe the current use of\n                    contrast-enhanced ultrasound in Saudi Arabia, identify barriers to its adoption,\n                    and propose strategies to support wider clinical utilization.<\/jats:p>\n                  <jats:p>Materials and methodsA cross-sectional online survey was distributed to\n                    more than 5,000 healthcare practitioners between July and October 2025.\n                    Ninety-two eligible responses were included and analyzed using descriptive\n                    statistics. An additional qualitative input was obtained from contrast agent\n                    suppliers to contextualize survey findings.<\/jats:p>\n                  <jats:p>ResultsClinical use of contrast-enhanced ultrasound was limited, with 79%\n                    of respondents reporting no current application. Among active users, most\n                    performed one to five contrast-enhanced ultrasound examinations per month.\n                    Formal contrast-enhanced ultrasound training was uncommon, despite strong\n                    interest in education. Major barriers included lack of training opportunities,\n                    low clinical awareness, regulatory constraints, and limited availability of\n                    contrast-enhanced ultrasound-capable equipment. Supplier feedback corroborated\n                    these barriers and highlighted the need for structured education and research\n                    collaboration.<\/jats:p>\n                  <jats:p>ConclusionsContrast-enhanced ultrasound is markedly underutilized in Saudi\n                    Arabia, primarily due to educational, regulatory, and resource-related barriers.\n                    These findings support national initiatives to expand access, enhance training\n                    programs, and promote integration of contrast-enhanced ultrasound into routine\n                    clinical and research practice.<\/jats:p>","DOI":"10.1055\/a-2899-0967","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:29:02Z","timestamp":1783985342000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Barriers to the Broader Use of Contrast-Enhanced Ultrasound in Saudi\n                    Healthcare and Medical Research"],"prefix":"10.1055","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0579-0390","authenticated-orcid":false,"given":"Shatha Jamal","family":"Almushayt","sequence":"additional","affiliation":[{"name":"Princess Nourah bint Abdulrahman\n                    University, Saudi Arabia","place":["Riyadh"],"department":["Department of Radiological Sciences, College of Health and\n                    Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/1742271X18762250","article-title":"Vascular ultrasound, the potential of integration of multiparametric ultrasound\n                    into routine clinical practice","volume":"26","author":"V Rafailidis","year":"2018","journal-title":"Ultrasound"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1055\/a-1177-0530","article-title":"Guidelines and good clinical practice recommendations for Contrast Enhanced\n                    Ultrasound (CEUS) in the liver\u2014update 2020\u2014WFUMB in cooperation with EFSUMB,\n                    AFSUMB, AIUM, and FLAUS","volume":"41","author":"C F Dietrich","year":"2020","journal-title":"Ultraschall Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1055\/a-0586-1107","article-title":"The EFSUMB guidelines and recommendations for the clinical practice of\n                    Contrast-Enhanced Ultrasound (CEUS) in non-hepatic applications: Update 2017\n                    (Long version)","volume":"39","author":"P Sidhu","year":"2018","journal-title":"Ultraschall Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3390\/diagnostics7030053","article-title":"The 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Santarelli","year":"2024","journal-title":"Life"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"111453","DOI":"10.1016\/j.ejrad.2024.111453","article-title":"Contrast-enhanced ultrasound (CEUS) for the characterization of intra-scrotal\n                    lesions","volume":"175","author":"P S Benjamin","year":"2024","journal-title":"Eur J Radiol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"5469","DOI":"10.3390\/cancers13215469","article-title":"Performance of contrast-enhanced ultrasound in thyroid nodules: Review of\n                    current state and future perspectives","volume":"13","author":"M Radzina","year":"2021","journal-title":"Cancers"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"293","DOI":"10.11152\/mu-4382","article-title":"How CEUS improves gallbladder pathology evaluation. A comprehensive pictorial\n                    and review of the literature","volume":"26","author":"A F Badea","year":"2024","journal-title":"Med Ultrason"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12947-024-00330-2","article-title":"Ultrasound enhancing agents in cardiovascular imaging: expanding horizons beyond\n                    coronary arteries","volume":"22","author":"A Albulushi","year":"2024","journal-title":"Cardiovasc Ultrasound"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1177\/02683555241308317","article-title":"Review of the literature on the use of contrast-enhanced ultrasound (CEUS) in\n                    vascular malformations","volume":"40","author":"A Achiti","year":"2025","journal-title":"Phlebology"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"100254","DOI":"10.1016\/j.jvsvi.2025.100254","article-title":"Clinical applications of contrast-enhanced ultrasound in vascular surgery:\n                    State-of-the-art narrative and pictorial review","volume":"3","author":"A N Abou Ali","year":"2025","journal-title":"JVS-Vasc Insights"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s11547-025-02055-2","article-title":"How useful is contrast-enhanced ultrasound in rheumatoid arthritis? 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