Diffusion restriction, midline crossing, and mixed morphology on VASARI MRI stratify recurrence risk in pleomorphic xanthoastrocytoma

In pleomorphic xanthoastrocytoma, VASARI MRI features—diffusion restriction (HR 5.10), midline crossing (HR 3.82), mixed cystic-solid morphology (HR 3.42)—predicted recurrence. Optimism-corrected C-index 0.79 (95% CI 0.70–0.86).

• The model achieved good discrimination but is hypothesis-generating and requires independent external validation before clinical application.
• The three predictive features are diffusion restriction, midline crossing, and mixed cystic-solid non‑classic morphology, all assessable on standard MRI without specialized postprocessing.

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