Panoramic Ghosting
A specific artefact in panoramic (OPG) radiography in which a dense structure on one side of the patient casts a blurred, elevated, and reversed secondary image on the contralateral side of the film.
Full Definition
Panoramic ghosting is an artefact unique to rotational panoramic radiography. As the X-ray beam rotates around the patient, dense objects (such as earrings, hearing aids, cervical vertebrae, or dental restorations) on one side of the focal trough may attenuate the beam and then appear as a ghost image on the opposite side of the panoramic image, typically higher and less sharp than the primary image. The ghost image is reversed (mirror image) relative to the real structure. Editors and report authors must correctly identify ghost images to avoid misdiagnosis; for example, a cervical spine ghost can simulate a radiopaque lesion in the midline of the mandible. This differs from a 'double image', which arises from patient movement.
Usage
Usage note: Distinguish clearly from the CBCT 'ghost artefact', which has a different mechanism. In reports, identify the causative real object and describe the ghost's position relative to it (contralateral side, superior, less well-defined).
In Context
- "A radiopaque band across the right ramus was identified as panoramic ghosting of the patient's left cervical spine, not a pathological finding." — Panoramic radiograph report
- "The report editor queried whether the described 'lesion' in the midline mandible was actually a panoramic ghost of the hyoid bone before finalisation." — Radiology report editorial review