tl;dr - After you've checked disk integrity, RAM, updated graphics driver, and disabled (if present) nahimic services, if you're having issues with download images corrupted on-disk (not just when displayed) like I was, try disabling the Remove roughly-matched duplicate images option and see if that makes a difference for you. It did for me.
Update... i redownloaded the media for my library (FWIW, it's almost entirely PC games) with Remove roughly-matched duplicate images (recommended) unselected (it was selected in all previous attempts).
and all (over 10K) images saved and downloaded fine.
I removed the antivirus and malware scan exclusions from the Launchbox Image folders and downloaded metadata+media for a bunch of new items added to my Steam and GOG accounts and there were no corruption issues with the new images either. So far it seems disabling the Remove roughly-matched duplicate images option has solved my issue.