This is total comfort food at it's best! You can sub the rotini pasta for medium shells but rotini is better. This recipe is made with roasted garlic, so if you are planning to make this wonderful dish, roast your garlic bulb way in advance or even a day ahead and refrigerate, I roast my garlic and store it in the freezer in small containers. You can use turkey sausage for this in place of Italian sausage.... This is a fantastic Italian-style dish. Cooking time does not include roasting the garlic.