Hi Sean,
I have produced pdf documents with images using Qimage and PDF Creator. You don't say what application you are using to "print" the pdf from Qimage.
I too used "let the printer/driver manage colour"
You will need to set the PDF "printer" correctly too, see attachment below which shows the PDF Creator settings I used. They were arrived at after some experimentation and confirmed by another member of the forum.
I don't know if pdf files are capable of having embedded colour profiles and if the Adobe In Design is colour management aware. You would need to discuss the detail with the printer.
One other option would be to give the printer an image file (jpeg or tiff) by using the Qimage Print to File function. Ask the printer the preferred format and resolution required so you can set up PTF correctly.
The printer may even have a profile you can embed with PTF, otherwise just go for sRGB.
Terry.
PS.
They were arrived at after some experimentation and confirmed by another member of the forum
Who seems to have forgotten what we did - Fred!