Evaluate latest version of PDFtk for image-filling

PDFtk had something of a reboot, and I contacted the author to see if he thought image-filling was possible. He was unsure, but wondered if I could combine ImageMagick with making a new page or something in order to achieve that. It sounded kind of feasible except for it not being clear how I would get the coordinates for where to place the image. But I'd like to look into it when I get a chance.