Yes you can still fresh install. With a fresh install, you'll have to install and configure your programs from scratch.
The benefits of a full system image backup is that you can restore to a known clean and stable build of your system with programs and settings still intact.
Technically you don't need additional software as Windows 10 still has the built-in Backup and Restore function that enables you to make a full system image backup. However, that feature is being depreciated which is why I recommended the free version of Macrium Reflect.