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3% ( = 4) of malignant lesions ( 0.0001). The sensitivity and specificity of RTE was 89.29% and 56.25% with PPV and NPV being 58.13% and 82.35%, respectively. Higher elastography score was found to be significantly associated with malignant histopathology ( = 0.004). Cancer detection rate with RTE was greater for tumors with higher Gleason score. RTE was found to have better sensitivity than TRUS as well as combination of TRUS and CD. Although less specific, RTE can be an effective adjuvant tool to TRUS for guidance of biop