Hi

possible, yes, very easy, no.

essentially , you should probably use the following filter (wppizza_cart_item – have a look in the wppizza-cart.php template where it is) and output something (div or whatever) in front of that li element (in the filter you would be able to access the id of that item and select an image accordingly) and then play with the css to align it

hope that helps

PS: the next version – hopefully out in a few days – will also – amongst a bunch of other things – have an id on the li element you could use somehow (will be something like id=’wppizza-cart-item-4.2′ where 4 would be the menu item id and 2 is the selected size)