We were pleased to read Karlas and Petroff’s comments addressing our article comparing magnetic resonance imaging (MRI) and transient elastography (TE) using the M probe for staging of liver fibrosis and grading steatosis in nonalcoholic fatty liver disease (NAFLD).1 We agree that TE-based controlled attenuation parameter (CAP) measurement is excellent for the detection of significant hepatic steatosis. However, its accuracy is impaired by an increased body mass index (BMI), and it is less accurate in distinguishing between the different grades of hepatic steatosis, especially severe steatosis.