Genhtml.exe supports image files with the following extensions (see genhtml -help):
JPG PDF GIF JPEG
Files with this extension are automatically added to index.htm .

Files with the same name as the image and one of the extensions htm txt (see genhtml -help) will be opened and the contents of these files will be added to index.htm.

This allows you to add comments to images. A WEB index server can be used to add the text-files to make the documentation searchable!

On the opposite you may enter the text into an editor and screen-shot this if you have to be very fast in documentation. But this approach has the disadvantage that an indexing server might not find any keywords.