We read with interest the recent reviews published in Gut , emphasising that even though the understanding of the pathobiology of liver fibrosis has been improved in the last three decades, 1 novel and easy to implement diagnostic and therapeutic approaches are required. 2 Indeed, fibrosis is the most important histological feature of patients with chronic liver disease (CLD), such as non-alcoholic fatty liver disease, and is associated with long-term overall mortality, liver transplantation and liver-related events. 3 Diagnostic and therapeutic approaches, 2 therefore, require accurate measurements that ideally allow non-invasive fibrosis quantification, representing the whole liver free of bias and easily integrated in clinical routine. A liver biopsy, still the reference standard, has substantial drawbacks (complications, intraobserver and interobserver variabilities). 4 Transient elastography (TE), suggested for population-wide screens (eg, patients with diabetes), 5 requires additional expensive devices and trained personnel. However, contrast-enhanced MRI is routinely performed...