Progress in the application of 68Ga-Pentixafor PET/CT in lung cancer: a review

68Ga-Pentixafor PET/CT, a molecular imaging technique targeting the C-X-C chemokine receptor 4 (CXCR4), has emerged as a promising tool in the diagnosis and therapeutic evaluation of lung cancer. Lung cancer remains a leading cause of cancer-related mortality worldwide, and accurate imaging modalities are critical for early detection, staging, and treatment monitoring. Current imaging approaches face challenges in differentiating tumor subtypes and assessing tumor biology, which limits personalized treatment strategies. This review systematically summarizes the application of 68Ga-Pentixafor PET/CT across various histological subtypes of lung cancer, including non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), and rare lung cancer variants. We emphasize the correlation between PET imaging findings and immunohistochemical CXCR4 expression, highlighting the diagnostic value and unique imaging characteristics of this modality. Additionally, the potential role of 68Ga-Pentixafor PET/CT in guiding radioligand therapy is discussed, alongside its utility in tumor staging, therapeutic response assessment, and individualized treatment planning. By integrating recent clinical studies and systematic evaluations, this review aims to elucidate the advantages and limitations of 68Ga-Pentixafor PET/CT, providing theoretical insights and practical guidance for advancing precision medicine in lung cancer management.