Cardiac imaging with bone-avid tracers for the diagnosis of transthyretin amyloid (ATTR) cardiac amyloidosis uses only limited quantification, but single-photon emission computed tomography/computed tomography (SPECT/CT) acquisition can provide volumetric assessment with quantification of tracer uptake. Tafamidis is routinely used in the treatment of cardiac amyloidosis, but there are scant data on changes in imaging results during therapy. The purpose of this study was to perform a longitudinal assessment of Tc-99m-pyrophosphate (PYP) imaging to determine if tafamidis therapy results in any change in quantitative measures of tracer uptake.