Preheat oven to 400 degrees F. Add tomatoes and garlic to a baking dish, lightly coat with olive oil spray, and season with salt and pepper. Roast for 20-25 minutes until soft.
Boil pasta until al dente. Reserve 1/2 cup of pasta water before draining.
Add roasted tomatoes, garlic, cottage cheese, and basil to a blender or food processor. Blend until completely smooth.
Pour the sauce into a pan over low heat. Add reserved pasta water a little at a time until the sauce becomes glossy and creamy.
Toss pasta with the sauce until fully coated. Top with basil, black pepper, and optional red pepper flakes.