There is a way to get the images from a library. You can use LibraryManager.GetLibrary and ILibrary object. Then you need to create an image using System.IO.MemoryStream and System.Drawing.Image using the data provided from LibraryManager. There is no built-in functionality for storing items in the file system. You can find the following post useful - physical upload of images and documents
. Here the idea is that you are storing only the metadata of a content item in the database, since the actual file size is stored in the file system.
I hope that this helps.
the Telerik team