Thanks for the writing.
Your approach is correct - you can remove an existing item and add a brand new item containing another image.
It is also possible to change only the image of the existing item, for example:
image2.Image = Image.FromStream(imageBuffer2);
((RadImageItem)radRotator1.Items).Image = image2;
I hope this will help. Do not hesitate to contact us if you have other questions.
the Telerik team
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system and vote to affect the priority of the items