The global obesity pandemic necessitates characterization of nonalcoholic fatty liver disease (NAFLD) in an extremely large and growing number of patients. This disease subsumes hepatic fat, inflammation, and fibrosis. Fibrosis is of particular interest, being the strongest predictor of mortality,1,2 and noninvasive techniques for assessing its severity are becoming part of routine care, at least in Asia and Europe.3 As we endeavor to understand NAFLD more fully, steatosis quantification has become increasingly successful, although we are still struggling to understand its clinical implications.