Nonalcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis occurring in those who do not consume high amounts of alcohol. The prevalence of NAFLD is high in the general population with metabolic risk factors and insulin resistance being mainly associated with overweight, diabetes, hyperlipidemia and hypertension [1, 2]. Two histological patterns of NAFLD have been described: fatty liver alone and, in a minority of patients, necroinflammatory form of NAFLD known as non-alcoholic steatohepatitis (NASH) that may progress to cirrhosis and hepatocellular carcinoma [1]. Although confirmation of the diagnosis of NAFLD can be achieved by imaging methods, they do not provide data
on staging the disease (steatohepatitis and fibrosis), which until recently required a liver biopsy for confirmation. Due to the high prevalence of NAFLD in at risk populations [1], the limitations of biopsy [3, 4] and the developing of reliable noninvasive blood tests [5-8], liver biopsy should no longer be considered mandatory as first-intention screening of liver lesions [9, 10].