PDF-tools uses the poppler pdf library for 'handling' the PDF's. As far as I know, it is not capable of adding images to existing PDF's. So the short answer is, no, it is not possible in a straightforward manner.
On the other hand, there is a working alternative pdf server written in python and using the (Py)MuPDF library, which, according to the PyMuPDF docs here should be able to add images to PDF's. The vimura server already adds some extra annotation features like 'line annotations'.
To use this server, you should use the pymupf-tq branch here, and additionally install the server from PyPi.
So if you really want it, you really like tinkering, and you know elisp well and python a little, then you could add this functionality to the vimura server, but it would probably take you a couple of hours (let's say a full day, depending how fast you code).
EDIT
B.t.w., because I consider this a worse alternative, I forgot to mention that it is also possible to do this without using the vimura server. Namely, you could use a tool like MuPDF, pdf-lib, or PyPDF2 to add the image. From the pop-up buffer, you can get the annotations info via pdf-annot-edit-contents--annotation
you can inspect pdf-annot-print-annotation-latex
find where the latex rendered image gets stored.
END EDIT