I don't know how to get rid of them. I suspect you don't need to worry about it though. The following is speculation-- about why they continue to appear when you use the add on. It's based on what happens in the server logs when you use the add on.
Ok... now. If I put an image on my web page-- making sure both the page and image are new, and then visit my page using the Image Exchange add on, with the 'sidebar' showing, my web page loads. Meanwhile, there is a pause in the Image Exchange. Eventually, the image exchange might find a match which appears in the sidebar. (Some "matches" can be pretty funny. I'd love to show some-- but I'm not sure it's fair use. But it can be hilarious.)
Anyway, if I then open up my server logs, I can see the "hits" to my page. I know my own IP (and my own user agent)-- so I see hits associated with my visit. Following a few seconds after my visit, I see hits from other IPs. When I've done the experiment in the past, these hits only hit the images, and moreover have blank user agents and blank referrers.
I diagnose these as being picscout. And what I think picscout does is fetches the image, compares it to the library and then "remembers" that image match is on that page. It probably remembers by putting storeing information about the matches with that page.
Now, what is the function of "remembering". Well, the other thing I notice is that if I visit the same page again, picscout does not visit unless I have added fresh images with fresh names. So, I think what happens is that unless the visitors browser sends information about a new image, picscout just "remembers" whatever it thought matched images to that page.
No, I"m guessing in your case, after you removed the image, picscout simply hasn't programmed anything to notice the image is no longer there, and it is still "remembering" an image supposedly matched what is there. Mind you-- if it had had a stupid match, it would be "remembering" something that never matched well in the first place. (Because that happens. Seriously-- I've loaded simple images of cross hatches and had it match it to things like a bird on a wire running diagonally across the sky. I assume the slanted lines 'matched' and that was enough for picscout.)
So, if this is what is happening;
1) You probably can't get picscout to 'forget' what was there. Because it's programmed to remember what used to match.
2) You don't need to worry about it. Because picscout makes lots of mistakes. So... the fact that it claimed an image once matched something that is no longer there proves nothing about what used to be there. (Mind you... if the subject ever comes up, do not voluntarily admit that the match was once correct. Maybe ask here, and I might be able to find the images of really truly bad matches I've had before. Seriously hilarious!)