Barriers to the Broader Use of Contrast-Enhanced Ultrasound in Saudi Healthcare and Medical Research.

Purpose The aim of this study was to describe the current use of contrast-enhanced ultrasound in Saudi Arabia, identify barriers to its adoption, and propose strategies to support wider clinical utilization. Materials and methods A cross-sectional online survey was distributed to more than 5,000 healthcare practitioners between July and October 2025. Ninety-two eligible responses were included and analyzed using descriptive statistics. An additional qualitative input was obtained from contrast agent suppliers to contextualize survey findings. Results Clinical use of contrast-enhanced ultrasound was limited, with 79% of respondents reporting no current application. Among active users, most performed one to five contrast-enhanced ultrasound examinations per month. Formal contrast-enhanced ultrasound training was uncommon, despite strong interest in education. Major barriers included lack of training opportunities, low clinical awareness, regulatory constraints, and limited availability of contrast-enhanced ultrasound-capable equipment. Supplier feedback corroborated these barriers and highlighted the need for structured education and research collaboration. Conclusions Contrast-enhanced ultrasound is markedly underutilized in Saudi Arabia, primarily due to educational, regulatory, and resource-related barriers. These findings support national initiatives to expand access, enhance training programs, and promote integration of contrast-enhanced ultrasound into routine clinical and research practice.