This is just my opinion... for locos with "typically-sized" flanges (and remember, there are no standards for the 3-rail side of the hobby), having another large flanged wheel AND the greater spacing between adjacent wheels needed to accommodate it makes the loco look worse / even more toylike than just leaving the center wheels unflanged.
For examples, look at late 1930s American Flyer O gauge. Or more recently, the Atlas Founders Series 0-6-0 steam switcher. Atlas tried very hard to build a 3R loco that was "scale" in every respect EXCEPT the large flanges needed to operate on our sharp curves, and of course the center rail pickup rollers. Unfortunately the wheels were plated with a shiny finish which accentuates the large flange. Do you want a slice of plain, or pepperoni?
Depending on how "tight" the loco is gauged, flanged center wheels may add friction even on O72 curves, and definitely on sharper ones. This will cause the loco to slow down in an unprototypical way, or at least make your speed control work harder to prevent a slow-down. The original 700E was slightly under-gauged and required the special T-rail track to run. I'm not sure how badly it slowed on 36" radius curves. Since then, Lionel and every other 3-rail manufacturer until Atlas omitted the flanges, even on diesels. So, for the sake of both appearance and performance, I personally wouldn't risk messing up a $1700 Vision Hudson by attempting to install flanged wheels on the center axle. My $.02.